Connected Insulin Pen (CIP) Toolkit
Patients Who Can Benefit From Connected Insulin Pens (CIPs)
People who may be able to benefit from CIPS are those with type 1 or type 2 diabetes who are on insulin injections but are not reaching their personal glycemic targets or are experiencing diabetes management fatigue and could use help with:
- Insulin initiation
- Mealtime dosing
- Dose reminders
- Digitally logging insulin and glucose data
- An insulin dose calculator
- Insulin on board or dose stacking
Although type 1 and type 2 diabetes are very different diseases, the challenges they bring are often similar when it comes to initiating and adjusting insulin therapy.
Choose one of the patient case videos below to see how with a CIP, Dr Lee finds a solution that works for 3 very different people with diabetes.
Adam: type 2 diabetes on basal + mealtime insulin
Adam is 59 years of age, has had type 2 diabetes for 10 years, is on mealtime insulin, and uses a blood glucose meter, or BGM, from which data can be downloaded in the office.
While his BGM readings are digitally recorded, Dr Lee has asked that Adam also record his insulin doses manually to review during their visits.
Adam tells Dr Lee, “I’m trying my best, but managing my diabetes is hard with my busy schedule.”
Adam: ”I’ve tried to write down my insulin doses like you ask, but it’s impossible to do when I'm on the go.”
This missing piece makes it challenging for Dr Lee to connect Adam’s blood glucose events to his insulin doses and confidently recommend insulin dose adjustments.
Dr Lee: “I appreciate your frustration. How would you feel about a device that could record your insulin doses automatically?”
Adam: “If it fits into my busy schedule, it sounds interesting.”
Dr Lee: “A connected insulin pen, or CIP, can connect to your phone to automatically record the brand of insulin, dose, date, and time of each injection in an app. A CIP helps us work together integrating all your glucose and insulin data into one place.”
Let’s look in on Adam’s follow-up visit 3 months later.
Adam: “Dr Lee, I've been so excited about this appointment! I feel like now I can’t even imagine not using a CIP.”
Dr Lee: “I’m so happy to hear that, Adam! On that note, let’s take a look at your CIP data together.”
When Dr Lee looks at Adam’s data, she has a clearer picture of his insulin dosing patterns. She can identify instances of inadequate doses, dose stacking, and missed doses all in the context of Adam’s daily glucose levels.
Dr Lee: “Adam, I can tell how much effort you’re putting in to adjusting your mealtime insulin doses. Let's see if we can fine-tune them together.”
With the data the CIP provides, Dr Lee can better tailor her visit with Adam to help address his specific insulin dosing patterns. This allows both Dr Lee and Adam to feel more confident in their diabetes management plan.
Bridget: type 1 diabetes on basal + mealtime insulin
Bridget is 25 years of age, was diagnosed with type 1 diabetes 19 years ago, is on a complex mealtime insulin regimen, and uses a continuous glucose monitor, or CGM.
Bridget is an experienced user of diabetes management software and insulin pens.
At today’s visit, she tells Dr Lee—
Bridget: “I got a promotion at work, and I’m traveling more. It's great, but I've been struggling with more frequent highs after meals.”
Dr Lee: “Looking at your glucose data, I see what you're saying about the highs after meals. I know how busy you are, but have you been able to log some of your insulin doses for us to look at?”
Bridget: “With all the travel and different time zones, I’ve had trouble keeping track. But I don’t want to go back to an insulin pump either. It wasn’t right for me.”
Dr Lee: “Yes, I’m sure traveling more makes keeping track of everything harder. Among other things that could be causing this pattern, knowing your insulin doses would be helpful. There is a tool that can help collect this kind of data that I can show you if you’re interested.”
Dr Lee explains to Bridget how a connected insulin pen, or CIP, might be the right solution to assist in her diabetes management.
Dr Lee: “CIP apps have calculators to help determine your insulin doses. A CIP also connects to your phone to automatically record the brand of insulin, dose, date, and time of each injection in the app. Integrating your glucose and insulin data into one place helps us work together.”
Dr Lee: “Would you be interested in trying a CIP?”
Bridget: “Yes, I’m interested!”
Bridget is back for her 3-month follow-up appointment. Let’s see how she has done.
Dr Lee: “Great to see you, Bridget! Tell me how it's going with the CIP.”
Bridget: “So far, so good! I’ve found the bolus calculator to be really helpful.”
Dr Lee: “That’s great! I know at our last visit you were struggling with spikes after you ate. Let’s look at your CIP report, which has both your CGM data and insulin doses.”
Bridget: “I’ve noticed improvement since I started using the dose calculator to help calculate my mealtime doses.”
Dr Lee: “I can’t wait to see. Let’s look at your most recent download.”
Dr Lee: “There is a lot less time when your curve goes above target after meals! I do think there is still more we can do to make sure you’re getting the right dose at the right time.”
With the dose calculation support the CIP app provides, Dr Lee and Bridget are able to implement appropriate and informed changes to improve Bridget’s insulin dosing plan.
Charles: type 2 diabetes on basal insulin
Charles is 64 years of age, has had type 2 diabetes for 7 years, is new to basal insulin, and uses a written logbook to record his blood glucose meter, or BGM, data.
Charles was started on 10 units of basal insulin at bedtime 6 months ago.
Dr Lee provided Charles with guidance on how to titrate his insulin. However, when Charles returns, he is still taking 10 units at 9:00pm.
With Charles, Dr Lee reviews his written BGM logbook. She sees that his fasting glucose remains elevated.
They discuss the apprehension that Charles feels about titrating his dose independently.
Charles: “I know you asked me to adjust my dose with the titration chart, but the first day it said to go up by 6 units! I was afraid I would go low.”
Dr Lee: “I appreciate how much effort it takes to manage your diabetes. I have a solution to help us work together on your logbook and dose titration. Let’s discuss an insulin pen that automatically records your insulin doses so you will have more support to make changes we can both be comfortable with.”
Charles: “I would like to see how it works.”
Dr Lee: “A connected insulin pen, or CIP, can connect to your phone to automatically record the brand of insulin, dose, date, and time of each injection in an app. CIP apps are also often compatible with Bluetooth-enabled BGM devices.”
Dr Lee: “A CIP integrates your glucose and insulin data in one place. I can also access the data anytime you would like me to review it, and it is always available for you to see.”
Charles has returned 3 months later for a follow-up appointment.
Dr Lee: “Great to see you again! We’ve made good progress titrating your insulin dose, and I’m glad we have the chance to review.”
Charles: “I was apprehensive initially, but you being able to see my insulin dose and glucose readings reassured me.”
Dr Lee: “You've done a great job!”
Dr Lee: “There must have been challenging moments, but I’m happy the CIP was a good fit!”
Charles: “Yes, I was scared in the beginning, but being able to communicate with the office really helped. Not having to write down my glucose readings and insulin doses was such a relief.”
With the help of a CIP, Dr Lee and Charles have established a productive and collaborative relationship moving forward with Charles’ diabetes management.
References
- ElSayed NA, Aleppo G, Aroda VR, et al. Standards of care in diabetes–2023. Diabetes Care. 2023;46(suppl 1):S1-S291.
VV-MED-154647
Please rate your satisfaction with the content on the following statements:
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied