Comparing Patch vs Pen Bolus Insulin Delivery in Type 2 Diabetes Using Continuous Glucose Monitoring Metrics and Profiles. (September 2022)

• Record Type: Journal Article
• Authors: Bergenstal, Richard M.; Johnson, Mary L.; Aroda, Vanita R.; Brazg, Ronald L.; Dreon, Darlene M.; Frias, Juan P.; Kruger, Davida F.; Molitch, Mark E.; Mullen, Deborah M.; Peyrot, Mark; Richter, Sara; Rosenstock, Julio; Serusclat, Pierre; Vance, Carl; Weinstock, Ruth S.; Levy, Brian L.
• Is Part Of: Journal of diabetes science and technology. Volume 16:Number 5(2022)
• Page Start: 1167
• Page End: 1173
• Publication Date: 2022-09
• Subjects: mealtime insulin -- patch -- CGM -- time in range -- TIR -- type 2 diabetes -- T2D -- SMBG -- algorithm; Diabetes -- Periodicals; Medical technology -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1177/19322968211016513
• Languages: English
• ISSNs: 1932-2968

Abstract

Objective: CeQur Simplicity™ (CeQur, Marlborough, MA) is a 3-day insulin delivery patch designed to meet mealtime insulin requirements. A recently reported 48-week, randomized, multicenter, interventional trial compared efficacy, safety and self-reported outcomes in 278 adults with type 2 diabetes (T2D) on basal insulin therapy who initiated and managed mealtime insulin therapy with a patch pump versus insulin pen. We assessed changes in key glycemic metrics among a subset of patients who wore a continuous glucose monitoring (CGM) device. Methods: Study participants (patch, n = 49; pen, n = 48) wore a CGM device in masked setting during the baseline period and prior to week 24. Glycemic control was assessed using international consensus guidelines for percentage of Time In Range (%TIR: >70% at 70-180 mg/dL), Time Below Range (%TBR: <4% at <70 mg/dL; <1% at <54 mg/dL), and Time Above Range (%TAR: <25% at >180 mg/dL; <5% at >250 mg/dL). Results: Both the patch and pen groups achieved recommended targets in %TIR (74.1% ± 18.7%, 75.2 ± 16.1%, respectively) and marked reductions in %TAR >180 mg/dL (21.1% ± 19.9%, 19.7% ± 17.5%, respectively) but with increased %TBR <70 mg/dL (4.7% ± 5.2%, 5.1 ± 5.8, respectively), all P < .0001. No significant between-group differences in glycemic improvements or adverse events were observed. Conclusions: CGM confirmed that the patch or pen can be used to safely initiate and optimize basal-bolus therapy using a simple insulin adjustment algorithm with SMBG. Preference data suggest that use of the patch vs pen may enhance treatment adherence.