Summary

Advice

The technology described in this briefing is d‑Nav. It is an app used for guiding insulin dosing for adults with type 2 diabetes.
The innovative aspects are the insulin dose can be calculated and adjusted based on a person's current and historic blood glucose levels on a weekly basis and without healthcare professional approval.
The intended place in therapy would be to help optimise insulin dosage in people with type 2 diabetes.
The main points from the evidence summarised in this briefing are from 4 studies (including 1 randomised controlled trial, 2 retrospective studies and 1 prospective pilot study) including a total of 611 adults with type 2 diabetes who use insulin. They show that d‑Nav can reduce haemoglobin A1c (HbA1c) levels in people when their current insulin dosing regimen is not reaching HbA1c targets.
Key uncertainties around the evidence or technology are that the 3 UK‑based studies are non-comparative. This means it is difficult to compare outcomes with standard care in the NHS. All evidence uses a version of the software installed on a physical d‑Nav device with built-in glucose meter.
Experts advised that the technology could automate daily insulin dosage requirements when there is not enough staff resource or frequent enough clinical visits to regularly titrate insulin dosage. However, patients need to be carefully selected and would need access to a smartphone and internet.
The cost of d‑Nav is about £100 per person per month (excluding VAT). This technology would be used in addition to routine diabetes monitoring appointments.