Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians’ Recommendations

Revital Nimri; Tal Oron; Ido Muller; Ivana Kraljevic; Montserrat Martín Alonso; Paivi Keskinen; Tanja Milicic; Asaf Oren; Athanasios Christoforidis; Marieke den Brinker; Lutgarda Bozzetto; Andrea Mario Bolla; Michal Krcma; Rosa Anna Rabini; Shadi Tabba; Lizl Smith; Andriani Vazeou; Giulio Maltoni; Elisa Giani; Eran Atlas; Moshe Phillip

doi:10.1177/1932296820965561

Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians’ Recommendations

Revital Nimri, Tal Oron, Ido Muller, Ivana Kraljevic, Montserrat Martín Alonso, Paivi Keskinen, Tanja Milicic, Asaf Oren, Athanasios Christoforidis, Marieke den Brinker, Lutgarda Bozzetto, Andrea Mario Bolla, Michal Krcma, Rosa Anna Rabini, Shadi Tabba, Lizl Smith, Andriani Vazeou, Giulio Maltoni, Elisa Giani, Eran AtlasMoshe Phillip

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

Aims: To compare insulin dose adjustments made by physicians to those made by an artificial intelligence-based decision support system, the Advisor Pro, in people with type 1 diabetes (T1D) using an insulin pump and self-monitoring blood glucose (SMBG). Methods: This was a multinational, non-interventional study surveying 17 physicians from 11 countries. Each physician was asked to provide insulin dose adjustments for the settings of the pump including basal rate, carbohydrate-to-insulin ratios (CRs), and correction factors (CFs) for 15 data sets of pumps and SMBG of people with T1D (mean age 18.4 ± 4.8 years; eight females; mean glycated hemoglobin 8.2% ± 1.4% [66 ± 11mmol/mol]). The recommendations were compared among the physicians and between the physicians and the Advisor Pro. The study endpoint was the percentage of comparison points for which there was an agreement on the direction of insulin dose adjustments. Results: The percentage (mean ± SD) of agreement among the physicians on the direction of insulin pump dose adjustments was 51.8% ± 9.2%, 54.2% ± 6.4%, and 49.8% ± 11.6% for the basal, CR, and CF, respectively. The automated recommendations of the Advisor Pro on the direction of insulin dose adjustments were comparable)49.5% ± 6.4%, 55.3% ± 8.7%, and 47.6% ± 14.4% for the basal rate, CR, and CF, respectively(and noninferior to those provided by physicians. The mean absolute difference in magnitude of change between physicians was 17.1% ± 13.1%, 14.6% ± 8.4%, and 23.9% ± 18.6% for the basal, CR, and CF, respectively, and comparable to the Advisor Pro 11.7% ± 9.7%, 10.1% ± 4.5%, and 25.5% ± 19.5%, respectively, significant for basal and CR. Conclusions: Considerable differences in the recommendations for changes in insulin dosing were observed among physicians. Since automated recommendations by the Advisor Pro were similar to those given by physicians, it could be considered a useful tool to manage T1D.

Original language	English
Pages (from-to)	364-372
Number of pages	9
Journal	Journal of diabetes science and technology
Volume	16
Issue number	2
DOIs	https://doi.org/10.1177/1932296820965561
State	Published - Mar 2022
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2020 Diabetes Technology Society.

Funding

The authors wish to thank Shiri Diskin, PhD, for her assistance in editing this manuscript. Part of this work was presented at the 12th International Conference on Advanced Technologies & Treatments for Diabetes, Berlin, Germany, February 20-23, 2019. The author(s) received no financial support for the research, authorship, and/or publication of this article.

Keywords

Advisor Pro
automated decision support
insulin pump settings adjustments
self-monitoring of blood glucose
type 1 diabetes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/1932296820965561

Cite this

Nimri, R., Oron, T., Muller, I., Kraljevic, I., Alonso, M. M., Keskinen, P., Milicic, T., Oren, A., Christoforidis, A., den Brinker, M., Bozzetto, L., Bolla, A. M., Krcma, M., Rabini, R. A., Tabba, S., Smith, L., Vazeou, A., Maltoni, G., Giani, E., ... Phillip, M. (2022). Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians’ Recommendations. Journal of diabetes science and technology, 16(2), 364-372. https://doi.org/10.1177/1932296820965561

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title = "Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians{\textquoteright} Recommendations",

abstract = "Aims: To compare insulin dose adjustments made by physicians to those made by an artificial intelligence-based decision support system, the Advisor Pro, in people with type 1 diabetes (T1D) using an insulin pump and self-monitoring blood glucose (SMBG). Methods: This was a multinational, non-interventional study surveying 17 physicians from 11 countries. Each physician was asked to provide insulin dose adjustments for the settings of the pump including basal rate, carbohydrate-to-insulin ratios (CRs), and correction factors (CFs) for 15 data sets of pumps and SMBG of people with T1D (mean age 18.4 ± 4.8 years; eight females; mean glycated hemoglobin 8.2% ± 1.4% [66 ± 11mmol/mol]). The recommendations were compared among the physicians and between the physicians and the Advisor Pro. The study endpoint was the percentage of comparison points for which there was an agreement on the direction of insulin dose adjustments. Results: The percentage (mean ± SD) of agreement among the physicians on the direction of insulin pump dose adjustments was 51.8% ± 9.2%, 54.2% ± 6.4%, and 49.8% ± 11.6% for the basal, CR, and CF, respectively. The automated recommendations of the Advisor Pro on the direction of insulin dose adjustments were comparable)49.5% ± 6.4%, 55.3% ± 8.7%, and 47.6% ± 14.4% for the basal rate, CR, and CF, respectively(and noninferior to those provided by physicians. The mean absolute difference in magnitude of change between physicians was 17.1% ± 13.1%, 14.6% ± 8.4%, and 23.9% ± 18.6% for the basal, CR, and CF, respectively, and comparable to the Advisor Pro 11.7% ± 9.7%, 10.1% ± 4.5%, and 25.5% ± 19.5%, respectively, significant for basal and CR. Conclusions: Considerable differences in the recommendations for changes in insulin dosing were observed among physicians. Since automated recommendations by the Advisor Pro were similar to those given by physicians, it could be considered a useful tool to manage T1D.",

keywords = "Advisor Pro, automated decision support, insulin pump settings adjustments, self-monitoring of blood glucose, type 1 diabetes",

author = "Revital Nimri and Tal Oron and Ido Muller and Ivana Kraljevic and Alonso, {Montserrat Mart{\'i}n} and Paivi Keskinen and Tanja Milicic and Asaf Oren and Athanasios Christoforidis and {den Brinker}, Marieke and Lutgarda Bozzetto and Bolla, {Andrea Mario} and Michal Krcma and Rabini, {Rosa Anna} and Shadi Tabba and Lizl Smith and Andriani Vazeou and Giulio Maltoni and Elisa Giani and Eran Atlas and Moshe Phillip",

note = "Publisher Copyright: {\textcopyright} 2020 Diabetes Technology Society.",

year = "2022",

month = mar,

doi = "10.1177/1932296820965561",

language = "אנגלית",

volume = "16",

pages = "364--372",

journal = "Journal of diabetes science and technology",

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Nimri, R, Oron, T, Muller, I, Kraljevic, I, Alonso, MM, Keskinen, P, Milicic, T, Oren, A, Christoforidis, A, den Brinker, M, Bozzetto, L, Bolla, AM, Krcma, M, Rabini, RA, Tabba, S, Smith, L, Vazeou, A, Maltoni, G, Giani, E, Atlas, E & Phillip, M 2022, 'Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians’ Recommendations', Journal of diabetes science and technology, vol. 16, no. 2, pp. 364-372. https://doi.org/10.1177/1932296820965561

TY - JOUR

T1 - Adjustment of Insulin Pump Settings in Type 1 Diabetes Management

T2 - Advisor Pro Device Compared to Physicians’ Recommendations

AU - Nimri, Revital

AU - Oron, Tal

AU - Muller, Ido

AU - Kraljevic, Ivana

AU - Alonso, Montserrat Martín

AU - Keskinen, Paivi

AU - Milicic, Tanja

AU - Oren, Asaf

AU - Christoforidis, Athanasios

AU - den Brinker, Marieke

AU - Bozzetto, Lutgarda

AU - Bolla, Andrea Mario

AU - Krcma, Michal

AU - Rabini, Rosa Anna

AU - Tabba, Shadi

AU - Smith, Lizl

AU - Vazeou, Andriani

AU - Maltoni, Giulio

AU - Giani, Elisa

AU - Atlas, Eran

AU - Phillip, Moshe

PY - 2022/3

Y1 - 2022/3

N2 - Aims: To compare insulin dose adjustments made by physicians to those made by an artificial intelligence-based decision support system, the Advisor Pro, in people with type 1 diabetes (T1D) using an insulin pump and self-monitoring blood glucose (SMBG). Methods: This was a multinational, non-interventional study surveying 17 physicians from 11 countries. Each physician was asked to provide insulin dose adjustments for the settings of the pump including basal rate, carbohydrate-to-insulin ratios (CRs), and correction factors (CFs) for 15 data sets of pumps and SMBG of people with T1D (mean age 18.4 ± 4.8 years; eight females; mean glycated hemoglobin 8.2% ± 1.4% [66 ± 11mmol/mol]). The recommendations were compared among the physicians and between the physicians and the Advisor Pro. The study endpoint was the percentage of comparison points for which there was an agreement on the direction of insulin dose adjustments. Results: The percentage (mean ± SD) of agreement among the physicians on the direction of insulin pump dose adjustments was 51.8% ± 9.2%, 54.2% ± 6.4%, and 49.8% ± 11.6% for the basal, CR, and CF, respectively. The automated recommendations of the Advisor Pro on the direction of insulin dose adjustments were comparable)49.5% ± 6.4%, 55.3% ± 8.7%, and 47.6% ± 14.4% for the basal rate, CR, and CF, respectively(and noninferior to those provided by physicians. The mean absolute difference in magnitude of change between physicians was 17.1% ± 13.1%, 14.6% ± 8.4%, and 23.9% ± 18.6% for the basal, CR, and CF, respectively, and comparable to the Advisor Pro 11.7% ± 9.7%, 10.1% ± 4.5%, and 25.5% ± 19.5%, respectively, significant for basal and CR. Conclusions: Considerable differences in the recommendations for changes in insulin dosing were observed among physicians. Since automated recommendations by the Advisor Pro were similar to those given by physicians, it could be considered a useful tool to manage T1D.

AB - Aims: To compare insulin dose adjustments made by physicians to those made by an artificial intelligence-based decision support system, the Advisor Pro, in people with type 1 diabetes (T1D) using an insulin pump and self-monitoring blood glucose (SMBG). Methods: This was a multinational, non-interventional study surveying 17 physicians from 11 countries. Each physician was asked to provide insulin dose adjustments for the settings of the pump including basal rate, carbohydrate-to-insulin ratios (CRs), and correction factors (CFs) for 15 data sets of pumps and SMBG of people with T1D (mean age 18.4 ± 4.8 years; eight females; mean glycated hemoglobin 8.2% ± 1.4% [66 ± 11mmol/mol]). The recommendations were compared among the physicians and between the physicians and the Advisor Pro. The study endpoint was the percentage of comparison points for which there was an agreement on the direction of insulin dose adjustments. Results: The percentage (mean ± SD) of agreement among the physicians on the direction of insulin pump dose adjustments was 51.8% ± 9.2%, 54.2% ± 6.4%, and 49.8% ± 11.6% for the basal, CR, and CF, respectively. The automated recommendations of the Advisor Pro on the direction of insulin dose adjustments were comparable)49.5% ± 6.4%, 55.3% ± 8.7%, and 47.6% ± 14.4% for the basal rate, CR, and CF, respectively(and noninferior to those provided by physicians. The mean absolute difference in magnitude of change between physicians was 17.1% ± 13.1%, 14.6% ± 8.4%, and 23.9% ± 18.6% for the basal, CR, and CF, respectively, and comparable to the Advisor Pro 11.7% ± 9.7%, 10.1% ± 4.5%, and 25.5% ± 19.5%, respectively, significant for basal and CR. Conclusions: Considerable differences in the recommendations for changes in insulin dosing were observed among physicians. Since automated recommendations by the Advisor Pro were similar to those given by physicians, it could be considered a useful tool to manage T1D.

KW - Advisor Pro

KW - automated decision support

KW - insulin pump settings adjustments

KW - self-monitoring of blood glucose

KW - type 1 diabetes

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Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians’ Recommendations

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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