{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:08:07Z","timestamp":1784092087164,"version":"3.55.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Matching insulin injection timing with meals to optimize postprandial glucose excursions is a daily challenge for individuals with diabetes on a multiple daily injection (MDI) regimen. We aimed to analyze the impact of using a connected insulin pen cap (CIPC) on insulin injection timing and glycemic control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design and methods<\/jats:title>\n                    <jats:p>\n                      Pragmatic, real-life, multicenter, prospective, open-label, observational study, including one week of run-in and a 6-week follow-up, split into a two-week masked mode phase and a four-week active phase. Continuous glucose monitoring (CGM) and automatically tracked insulin injection data in individuals with insulin-treated diabetes (ITD) who started using the CIPC Insulclock. The baseline and five hours of paired CGM and rapid-acting insulin data collected from\n                      <jats:italic>\n                        Insulclock v2.0\n                        <jats:sup>\u00ae<\/jats:sup>\n                      <\/jats:italic>\n                      users were analyzed using the ROC detection methodology to identify meal events and the timing of insulin doses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 82 recruited patients, 52 completed the study (54.4 y, 56.6% women, 60.4% with type 1 diabetes [T1D]) across three hospitals and one primary care center in Spain. The CGM glucometrics comparison between the consecutive masked and active phases showed: Glucose Management Indicator (GMI) 8.1\u00a0+\u00a01.7 vs 7.8\u00a0+\u00a01.4% (-0.3%, p 0.034); Time in Range 70-180 (TIR): 56.9\u00a0+\u00a024.5 vs 61.9\u00a0+\u00a021.6% (+5.0%, p 0.0054); Time below range &amp;lt;70 (TBR70): 2.5\u00a0+\u00a03.3 vs 1.76\u00a0+\u00a02.6% (-0.74%, p 0.0015); Time above range &amp;gt;180 (TAR180): 40.9\u00a0+\u00a025.3 vs 36.6\u00a0+\u00a022.4% (-5.3%, p 0.016). The on-time insulin injections increased: 45.5\u00a0+\u00a015.52 to 54.4\u00a0+\u00a016.6% (p 0.0017). The timing of insulin injection relative to the post-meal glycemic excursions shifted from +5.6 min (IQR \u201319.8 to +34.0) in the masked phase (n = 231 events) to \u20135.9 min (IQR \u201327.6 to +33.9) in the active phase (n = 467 events) (p = 0.023). An earlier injection was associated with a reduction in TAR180 (p = 0.042). Questionnaires measuring patients\u2019 reported outcomes (PROs) indicated a reduction in perceived treatment burden with the use of the\n                      <jats:italic>\n                        Insulclock v2.0\n                        <jats:sup>\u00ae<\/jats:sup>\n                      <\/jats:italic>\n                      CIPC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The use of\n                      <jats:italic>\n                        Insulclock v2.0\n                        <jats:sup>\u00ae<\/jats:sup>\n                      <\/jats:italic>\n                      connected insulin pen cap is associated with improved insulin injection timing and glucometrics.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1883791","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:47:39Z","timestamp":1784090859000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Improvement in insulin injection timing and glucometrics using a connected insulin cap: the Insulclock v2.0\u00ae prospective study"],"prefix":"10.3389","volume":"17","author":[{"given":"Fernando","family":"Gomez-Peralta","sequence":"first","affiliation":[{"name":"Endocrinology and Nutrition Unit, Hospital General de Segovia","place":["Segovia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Miguel","family":"Borrachero","sequence":"additional","affiliation":[{"name":"Centro de Salud del Peral","place":["Cartagena, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"Santos","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Service, Complejo Hospitalario Universitario de Burgos (HUBU)","place":["Burgos, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Abreu","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, Hospital General de Segovia","place":["Segovia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xo\u00e1n","family":"Valledor","sequence":"additional","affiliation":[{"name":"Research and Development Unit, Insulcloud S.L.","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Ruiz-Valdepe\u00f1as","sequence":"additional","affiliation":[{"name":"Research and Development Unit, Insulcloud S.L.","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Corcoy","sequence":"additional","affiliation":[{"name":"Institut de Recerca, Hospital de la Santa Creu i Sant Pau","place":["Barcelona, Spain"]},{"name":"Departament de Medicina, Universitat Aut\u00f2noma de Barcelona","place":["Bellaterra, Barcelona, Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Bioingenier\u00eda, Biomateriales y Nanomedicina (CIBER-BBN)","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1177\/19322968211028268","article-title":"Trends in U.S. insulin use and glucose monitoring for people with diabetes: 2009-2018","volume":"16","author":"Perez-Nieves","year":"2022","journal-title":"J Diabetes Sci 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