989-P: Type 1 Diabetes: Real-World Insulin Injection Patterns

Multiple daily insulin injections are an integral part of life for patients with type 1 diabetes (T1D). Moreover, patients’ schedules can change from day-to-day, further complicating T1D management. This study aimed to analyze daily injection patterns for patients with T1D. This post-hoc observational study included children and adults with T1D from Sweden using NovoPen® 6 with bolus insulin (primarily insulin aspart) and/or basal insulin (primarily insulin degludec). Injection data were uploaded via the Glooko® cloud system. Daily bolus and basal injections timing profiles were documented, weighting each dose relative to the total daily dose. Time difference between two consecutive basal insulin injections was used to evaluate basal timing variation. In total 159 adults and 47 children were included in the analysis, with a total of 38678 days of bolus injections and 17869 days of basal injections. The mean bolus daily injection profile displayed peaks at typical mealtimes but with substantial variation across patients and between adults and children (Figure 1). In those receiving insulin degludec timing of consecutive basal injections differed by more than 6 hr in ∼9% of the injections for adults and 7% for children. These real-world data give a unique insight into the bolus and basal adherence of pediatric and adult patients with T1D. Furthermore, the results illustrate the flexibility needed for basal injections to enable optimal management of T1D.