The d-Nav Insulin Guidance Service is a technology-enabled managed
service providing automated insulin dosage titration for patients using
basal, premixed, and basal-bolus insulin regimens with and without carb
counting. When implemented in a Trust in Northern Ireland mean HbA1c
decreased and patient satisfaction was high. Meanwhile, cost effectiveness
analysis demonstrates that d-Nav is cheaper than the current standard of care.
Achieving good glycaemic control in type 2 Diabetes is important to prevent mortality and costly
complications. Unfortunately achieving good glycaemic control in people with type 2 Diabetes is a worldwide
challenge. Standard UK clinical practice is to start with dietary and lifestyle modification, progressing to
antidiabetic drug therapy when glycaemic control is no longer achieved and intensifying drug therapy
if the patient remains above target. Yet even when using insulin many patients still fail to achieve
glycaemic control targets - many patients are only seen for dosage adjustment every six months.
To improve glycaemic control using the technology-enabled d-Nav insulin guidance service for patients with
type 2 diabetes using insulin in South Eastern HSC Trust. To show that d-Nav is more cost effective than the
current standard of care, making better use of insulin and reducing use of concomitant medications.
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