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. 2016 Jun 28;10(4):977-80.
doi: 10.1177/1932296815626457. Print 2016 Jul.

Unknown Safety and Efficacy of Smartphone Bolus Calculator Apps Puts Patients at Risk for Severe Adverse Outcomes

Irl B Hirsch  1 , Christopher G Parkin  2
Affiliations

Unknown Safety and Efficacy of Smartphone Bolus Calculator Apps Puts Patients at Risk for Severe Adverse Outcomes

Irl B Hirsch et al. J Diabetes Sci Technol. .

Abstract

Manual calculation of bolus insulin dosages can be challenging for individuals treated with multiple daily insulin injections (MDI) therapy. Automated bolus calculator capability has recently been made available via enhanced blood glucose meters and smartphone apps. Use of this technology has been shown to improve glycemic control and reduce glycemic variability without changing hypoglycemia; however, the clinical utility of app-based bolus calculators has not been demonstrated. Moreover, recent evidence challenges the safety and efficacy of these smartphone apps. Although the ability to automatically calculate bolus insulin dosages addresses a critical need of MDI-treated individuals, this technology raises concerns about efficacy of treatment and the protection of patient safety. This article discusses key issues and considerations associated with automated bolus calculator use.

Keywords: MDI; bolus advisor; bolus calculator; diabetes; insulin; multiple daily insulin injections; smartphone.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: IBH serves as an advisory board member for Abbott Diabetes Care, Roche, and Becton Dickinson. He receives research grant support from Novo Nordisk and Sanofi-USA. CGP has received consulting fees from Animas, CeQur, Dexcom, and Roche Diabetes Care.

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References

    1. Edelman S, Dailey G, Flood T, Kuritzky L, Renda S. A practical approach for implementation of a basal-prandial insulin therapy regimen in patients with type 2 diabetes. Osteopath Med Prim Care. 2007;1:9. - PMC - PubMed
    1. Weng J, Li Y, Xu W, et al. Effect of intensive insulin therapy on beta-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes: a multicentre randomised parallel-group trial. Lancet. 2008;371(9626):1753-1760. - PubMed
    1. Zhou J, Jia W, Bao Y, et al. Glycemic variability and its responses to intensive insulin treatment in newly diagnosed type 2 diabetes. Med Sci Monit. 2008;14(11):CR552-558. - PubMed
    1. Heinemann L. Overcoming obstacles: new management options. Eur J Endocrinol. 2004;151(suppl 2):T23-T27. - PubMed
    1. Ziegler R, Cavan DA, Cranston I, et al. Use of an insulin bolus advisor improves glycemic control in multiple daily insulin injection (MDI) therapy patients with suboptimal glycemic control: first results from the ABACUS trial. Diabetes Care. 2013;36(11):3613-3619. - PMC - PubMed