The d-Nav Way
An array of interventions currently exist to treat diabetes. Yet all but one—insulin—have limited efficacy. Studies demonstrate the long-term benefits of insulin therapy. However, their positive results have not been achieved in the broader population because insulin therapy places heavy demands on both patients and the healthcare system.
Can you imagine seeing your physician every week on a regular basis? For many people who use insulin to manage their diabetes, that’s what it would take to achieve optimal HbA1c levels. This becomes clearer when we look at the insulin needs of an individual patient.
The chart below shows a single patient’s insulin needs over two and a half years. Each box represents the total amount of insulin per day that was needed in a given week. For example, the patient was started at 90 units of insulin per day. In the weeks that followed, that number rose from 90, to 93, to 96, all the way up to 109 daily units of insulin before the end of month 2. Rather than staying steady at 109 units, this patient’s insulin needs then began to drop—falling as low as 76 units by month 6. Over the two-and-a-half-year period, this patient needed as little as 60 insulin units per day and as much as 120 insulin units per day. Without frequent dosage adjustments, it is not possible to adequately support such a patient, who would typically be seen in clinic 3 times per year.
This particular patient injects insulin four times per day at breakfast, lunch, dinner, and bedtime. Each injection contains a different amount of insulin because insulin needs are influenced by metabolism, which fluctuates throughout the day. Sometimes it may be necessary to raise one dose while maintaining or lowering another. For example, in one 4-month period (July-November, 2013) this patient’s bedtime dose was raised and lowered several times, while the dinner dose remained steady. In patients with advanced diabetes, these kinds of fluctuations are not unusual. They require frequent adjustments in insulin dosage based on blood glucose patterns. Making these adjustments without the help of a healthcare professional can be difficult and intimidating—even for those who have received patient education.
We believe we can help people effectively manage their diabetes. Hygieia has developed the d-Nav Insulin Guidance Service to provide adjustments to insulin therapy as often as needed. It is designed for insulin users who are not yet achieving optimal results.
d-Nav acts like an extension of your diabetes care team. The d-Nav device houses specialized software that increases insulin dosage when sugar patterns are above target and decreases insulin dosage when sugar patterns are below target. In addition, d-Nav has a built-in glucose sensor so there is no need to manually enter blood glucose levels.
We recognize that technology is not enough for patients seeking to optimize their blood sugar levels. For this reason, the d-Nav service includes nursing support. Our nurses communicate with patients in person and by phone. This one-on-one support gives d-Nav users the knowledge and confidence to adjust their own insulin dosage and achieve success.
Similar to a GPS, d-Nav functions as a guide for insulin users. It knows your destination and the roads that lead there. If it senses that you’ve taken a wrong turn, d-Nav immediately alerts you, providing directions so that you can resume your journey on a better path.
By empowering people with diabetes to adjust their insulin dosage, the d-Nav service provides a scalable and practical solution for diabetes management. We believe it can transform the current standard of care—and transform the lives of people.
- Bashan et al. A novel approach to optimise glycaemic control in insulin users. BMJ Case Rep. 2015 Jul 31;2015
- Donnelly et al. Diabetes Insulin Guidance System: a real-world evaluation of new technology (d-Nav) to achieve glycaemic control in insulin-treated type 2 diabetes. Practical Diabetes 2015 Sep;32(7):247–252a
- Bergenstal et al. Can a tool that automates insulin titration be a key to diabetes management? Diabetes Technol Ther. 2012 Aug;14(8):675-82
- Bashan et al. Are glucose readings sufficient to adjust insulin dosage? Diabetes Technol Ther. 2011 Jan;13(1):85-92
- Bashan et al. Frequent insulin dosage adjustments based on glucose readings alone are sufficient for a safe and effective therapy. J Diab. Comp. 2012 May-Jun;26(3):230-6
- Rosenthal et al. The effort required to achieve and maintain optimal glycemic control. J Diab. Comp. 2011 Sep-Oct;25(5):283-8