Zucchini S.,Centro Regionale per la Diabetologia Pediatrica |
Maltoni G.,Centro Regionale per la Diabetologia Pediatrica |
Scipione M.,Centro Regionale per la Diabetologia Pediatrica |
Balsamo C.,Centro Regionale per la Diabetologia Pediatrica |
Rollo A.,Centro Regionale per la Diabetologia Pediatrica
Giornale Italiano di Diabetologia e Metabolismo | Year: 2012
We assessed the efficacy of an automatic bolus calculator (Accu-Chek ® Aviva Expert) in a 30-day observational study in 30 children with type 1 diabetes who had already learned to count carbohydrates (carbo-counting). The primary end-point was the percentage of within-target glucose values two hours after meals. Fifteen children were randomized to use the Accu-Chek ® Aviva Expert calculator, and 15 used the Accu-Chek ® Aviva Nano glucometer and calculated the boluses manually. hey were all seen at three visits (0, 15, 30 days) and HbA 1c (DCA 2000) was measured at the start and end of the study. Glucose patterns were better in the group using the Aviva Expert calculator and their after-breakfast and after-dinner glucose values were lower than in the patients calculating their boluses manually. The group using the bolus calculator had a significantly higher frequency of within-target glucose values than the other group (67% vs 25%, p = 0.036). The frequency of hypoglycemic episodes (< 60 mg/dl) and the average number of correction boluses were similar in both groups. HbA 1c was 0.5% lower than baseline in the Aviva Expert group and 0.3% in the control group (p < 0.05). These findings indicate that an automatic bolus calculator (Aviva Expert) may be helpful in improving metabolic control, possibly by reducing errors in calculating bolus insulin doses. Long-term trials are needed to confirm these results and to determine whether the automatic calculator use improves clinical outcomes and glucose variability.