2103-P: Evaluating the Utility of the “Smart” InPen Wireless-Enabled System to Improve Glycemic Control and Diabetes Numeracy in Pediatric Type 1 Diabetes (EMPOWER Study)

Introduction and Objective: Mealtime insulin dosing requires complex calculations that can be challenging for teens with uncontrolled type 1 diabetes (T1D), especially those who have limited math skills. Diabetes numeracy in pediatric T1D is not well characterized. In this study we evaluated the utility of using the InPen™and its management app to improve glycemic control and diabetes numeracy in pediatric T1D. Methods: A single-arm 24-week pilot study examining change in glycemic control among adolescent and young adults with uncontrolled T1D at 12 and 24-weeks after using the InPen. The Diabetes Numeracy Test (DNT-14) was administered at baseline and 24- weeks to better understand any relationship between intervention and glycemic control. Results: This study enrolled 17 patients of whom 82.4% were African Americans, 64.7% were male, mean age of 16.8 (12 - 21.7) years, and duration of diabetes of 7.2 (0.5 - 14.8) years. Mean HbA1c did not change significantly from baseline (11.2%) to 24 weeks following InPen use (10.8%). Participants overall had poor diabetes numeracy at baseline (mean of 53.8% correct answers) and scored lowest in the nutrition domain (31.4% correct answers, p < 0.001). DNT-14 scores in blood glucose monitoring and insulin administration domains were significantly associated with glycemic control and duration of diabetes (β=-11.2 and β= 3.3, respectively; p < 0.01 and 0.05). Conclusion: Assessment of diabetes numeracy in urban teens with uncontrolled T1D may provide new insights for better targeted interventions in diabetes education and technology to help improve health outcomes.