TightRate: New Mobile App Offers Remote Insulin Titration to Achieve Lasting Targeted Glucose Levels with Patients
Nearly 40 million people, or 11 percent of the population, had diabetes in 2019, which remains the 7th leading cause of death in the U.S. Diabetes, particularly type 2, is rising at an alarming rate, and remains a complex and unrelenting disease requiring frequent doctor patient communication. A major problem impedes diabetes care today, as medical providers can only prescribe insulin doses to patients verbally or in writing at or between appointments. Titration instructions, when rarely given, must be very simple to be safely followed by most patients. TightRate, a novel mobile application from University of Pittsburgh researchers, solves this issue by allowing a medical provider to prescribe an insulin dose adjustment algorithm to a patient remotely at any time. A key feature of TightRate is a settings section which enables the provider to choose initial doses, fasting, pre-meal, and post- meal glucose target ranges, , glucose target for correction doses, and a self-adjusting insulin sensitivity factor.. The provider can also adjust the frequency and magnitude of dose changes, personalized for the individual patient’s safety and urgency of reaching targets. For diabetes patients with a cellular signal, TightRate can offer them continuous, watchful care from a remote provider. This invention will not only improve an endocrinologist’s practice but will give diabetes patients a better quality of life by quickly achieving, and stably maintaining, personalized target glucose levels.
Description
TightRate works by using glucose data, insulin dose data, carbohydrate intake (if carb counting), and CGM arrow data (if using a CGM), from the current day and the past 1-7 days, to provide the patient with the dose of insulin to give before the current meal or the long acting insulin daily. The current meal-specific premeal base dose is determined by the change in glucose from before said meal to 2 or 4+ hours later, for the day or days prior. A linear equation is used to adjust the dose given the day before (that included the glucose and arrow correction) up or down by a percentage. The slope and intercept of the equations, as well as the maximum and minimum increase and decrease percentages, determine how aggressively the doses can be changed, and therefore how long it will take to achieve the adequate doses. The initial algorithm was designed to achieve euglycemia within 2 weeks in patients recently diagnosed with type 2 diabetes, in an effort to achieve diabetes remission.Applications
• Patients with type 1 and type 2 diabetes• Pregnancy and other temporary insulin use
• Endocrinologists
• Diabetes clinics
• Other diabetes healthcare provider
Advantages
• Provider can adjust glucose targets and frequency / aggressiveness of dose titrations remotely at any time• Basal, carb/meal coverage, and corrections can be titrated simultaneously
• Patients can see their real time data with cellular signal
• Diabetes patients with different regimens and risks benefit from this App
• Once at goal, the app can maintain glucose levels safely, remotely