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A novel approach to optimise glycaemic control in insulin users
  1. Eran Bashan1,
  2. Roy Harper2,
  3. Yixi Bi3,
  4. Israel Hodish1,4
  1. 1Hygieia Inc, Ann Arbor, Michigan, USA
  2. 2Diabetes Center, Ulster Hospital, South East and Social Care Trust, Belfast, Northern Ireland, UK
  3. 3Queen's University, Belfast, Northern Ireland, UK
  4. 4Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan Medical Center, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Israel Hodish, ihodish{at}


Insulin therapy has been available for almost a century. However, its success rate is still disappointing where the majority of users sustain harmfully elevated glycated haemoglobin (HbA1c) levels. The key element essential for effective and safe insulin therapy is frequent dosage titration to overcome constant variations in insulin requirements. In reality, dosage titration is done sporadically during clinic visits. A scalable solution to this problem is being reviewed. A diabetes nurses service improves glycaemic control without overburdening the health system. The service relies on a handheld device, which provides patients with an insulin dose recommendation for each injection while using the device to monitor glucose. Similar to the approach providers use during clinical encounters, the device analyses stored glucose trends and constantly titrates insulin dosage without care providers’ supervision. In this report, we describe the logic behind the technology by providing examples from users.

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