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Sanofi at ATTD 2019: 12th International Conference on Advanced Technologies & Treatments for Diabetes
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Facilitating decisions on effective insulin dose adjustment for people living with diabetes. Background: Understanding the barriers that can prevent a patient from adjusting their insulin dose successfully

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Most of the effect of long-acting insulin to reduce blood sugar is obtained during the first 8–12 weeks of treatment,1 and results in this period are a good predictor of midto long-term blood sugar control in routine clinical practice.2 During this time, the daily dose is usually increased gradually until the optimal dose is found. After this period, which is referred to as the “titration phase”, the insulin dose is typically kept stable to maintain blood sugar control, and only adjusted to mitigate low blood sugar events or if blood sugar levels continue to rise.


Patients play a key role in managing dose adjustment during the first 12 weeks of insulin treatment. The Take Control study4 showed that patient-led insulin dose adjustment can achieve effective control of blood sugar levels.


Sanofi’s digital titration solutions, implemented within a blood glucose meter (MyStar DoseCoach®) and in a smartphone app (My Dose Coach™), plus collaborations with Voluntis including the Insulia®5 smartphone application, are all being used by people with diabetes in ten pilot programs and four active commercial launches around the world. These tools use patients’ daily blood sugar measurements to recommend a dose, aligned with a blood sugar target agreed with their physician.


People living with diabetes achieved a 2.7% reduction in average blood sugar using a digital titration solution to support initiation of long-acting insulin


People starting long-acting insulin to treat type 2 diabetes used the My Dose Coach™ digital insulin titration solution to guide dose adjustment and achieved a 2.7% reduction over the first 12 weeks of treatment. These results were presented today by Sanofi at a symposium during the 12th International Conference on Advanced Technologies & Treatments for Diabetes (ATTD), in Berlin, Germany.4


“Patients typically start long-acting insulin at 10 units per day, adjusting upward as necessary to achieve long-term treatment goals. Achieving these goals depends on patients receiving and following guidance on dose adjustment,” said Gilles Litman, Vice-President, Head of Global Integrated Care at Sanofi. “Importantly, integrating care by using a digital tool to support this provides multiple touchpoints and consistent advice, while reducing the burden on physicians.”


The pilot study, which involved 137 adults with type 2 diabetes, was conducted at Apollo Sugar Clinics across India. Participants were trained to measure their blood sugar levels each morning (fasting self-measured blood glucose, fSMBG). They entered this reading into the My Dose Coach™ app, which used the data to recommend a daily dose of insulin glargine 100 units/mL, aiming to help them achieve their blood sugar target without experiencing a low blood sugar event (hypoglycemia).


At the end of the 12-week period, average blood sugar level (HbA1c) was decreased by 2.7 percentage points from 9.9% to 7.2%, with an average insulin dose increase of 7 units, while 38 percent of participants achieved the <7% average blood sugar target recommended by bodies such as the American Diabetes Association (ADA). No incidents of symptomatic low blood sugar or hospitalization due to low blood sugar were reported during the study.


A new perspective on a personalized healthcare experience


With ever-increasing rates of diagnosis and the growing number of people keen to manage their health, we at Sanofi are exploring new paths for a better care experience.


Our commitment is to unlock innovative healthcare solutions for people living with chronic conditions, because these people should be empowered to manage their own health.


In this era of connectivity, all people should benefit from the best existing technology to be able to live the life they want, anywhere, anytime.


We are connecting ecosystems together to aggregate multiple flows of data, transforming people’s raw data into meaningful solutions, and using reliable information to personalize health management. By teaming up with people, their healthcare providers, and tech partners, we provide integrated solutions, giving people access to effort-saving solutions and actionable guidance to build longlasting healthy habits.


As of today, more than 8,000 people use our dose adjustment and digital engagement solutions in seven countries worldwide, enabling us to test and learn from real-life experience.


At Sanofi, we believe in a world where we partner with people to make healthcare more accessible, more predictable and with seamless personalized integrated care.


References

1. Owens DR, et al. Diabetes Res Clin Pract. 2014;106:264-74.

2. Mauricio D, et al. Diabetes Obes Metab. 2017;19:1155–64.

3. Sanofi, “A 24-Week, Multicenter, Randomized, Open-Label, 2-Arm Parallel-Group Study Evaluating the Efficacy and Safety of Patient- Versus Physician-Managed Titration of Insulin Glargine U300 in Type 2 Diabetes Mellitus”, available via https://www.clinicaltrialsregister.eu/ctr-search/trial/2015- 001626-42/results [Accessed February 2019].

4. Shah S, et al. “App-based Approach to Basal Insulin Titration: Initial Results of the My Dose Coach Pilot in India”, ATTD 2019.

5. Insulia® is a registered trademark of Voluntis

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