Effectiveness of Using a Digital Ecosystem for Ambulatory Diabetes Care in Patients Diagnosed With Type 2 Diabetes Mellitus

Abstract

Background: Evidence of efficacy and safety of digital ecosystems in Latin America is scarce, which has limited their implementation. The objective of this study is to evaluate the safety and efficacy of the use of a digital ecosystem (Zutrics) in people with Type 2 Diabetes (PwT2D) treated with insulin. Methods: Analytical observational prospective cohort study in PwT2D, treated with insulin and oral or injectable antidiabetics, with HbA1c >8%, and followed up with a digital ecosystem (Zutrics). HbA1c and derived time in range (TIRd 70-180 mg/dL) were evaluated at baseline and at 3-month follow-up. Additionally, hypoglycemia events were evaluated during the follow-up. Results: We analyzed 69 patients (age 62 ± 12.5 years, 56.6% female), 45.1% had chronic kidney disease (CKD) and 25.4% coronary artery disease. About 45.1% were on multiple dose insulin treatment. Median HbA1c levels decreased from a baseline value of 9.1% (interquartile range, IQR 7.5-11.4) to 7.0% (IQR 6.3-8.08) at 3-month follow-up (P = .044). The median of HbA1c changes over time was −1.3% (IQR −0.13, −4.2). The mean TIRd of 70 to 180 mg/dL increased from 74% at baseline to 76.1% at the end of follow-up. The TBRd of <70 mg/dL did not change significantly, going from 0.5% at baseline to 0.94% The incidence density of hypoglycemia episodes was 0.009 events/patient-day during the follow-up. About 95.6% of patients met the goal of TBRd <70 mg/dL less than 4% Conclusion: This study suggests that the use of a digital ecosystem in the follow-up of PwT2D allows better glycemic control without increasing the risk of hypoglycemia.