The Mobile Insulin Titration Intervention (MITI) for Insulin Adjustment in an Urban, Low-Income Population: Randomized Controlled Trial.

Source: Levy, N., et al. 2015 - Pubmed ID: 26187303

Setting: USA, Hospital

Study design:



Follow up: 12 weeks

Patient group:

Sample size:

Total: 61 (41)

IG: 33 (27)

CG: 28 (14)


Inclusion criteria:

  • Initiating insulin glargine or requiring the titration of an existing insulin glargine dose
  • HbA1c ≥ 8%
Type of technology:


  • Data transfer
  • Messaging


Phone call

  • Guidance

Intervention: Pt responds daily text messaging with their blood glucose value. Diabetes nurse monitor the values and call patient if values were alarming. Patients call nurse if needed. The nurse reviewed values once a week to adjust the insulin dose


Duration: 12 weeks
Add on: NA


Control group: Usual care

Clinical effect/ Patient safety:

Clinical effect:

  • Reaching optimal insulin glargine dose ↑
  • HbA1c →

Patient safety:
5 cases of hypoglycemia 3 in IG and 2 in CG

Patient experiences/ Staff experiences:

Patient experiences:

  • High (based on quotes)

Staff experiences:

  • Text messages reply rate 84.3%
  • Phone call reach rate 91%
  • Review blood glucose 1 min.
  • Titration review 7-11 min/pt
  • Phone call (mean) 11.2 minutes
Costs and organization:

Staff resources

  • Developing message system

Staff resources

  • Monitoring data
  • Phone call patients

Organization: NA


Health care utilization:

  • In person titration interaction ↓
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“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)