936-P: three-month interim analysis from the prospective bigfoot unity real world study (BURST)
Abstract
Background: The Bigfoot Unity® System is an FDA-cleared smart pen cap system incorporating CGM data (Abbott FreeStyle Libre 2), real-time alerts, and clinician-directed insulin dose recommendations. The objective was to analyze real world, 3-month data for System users. Methods: We conducted a per-protocol 3-month interim analysis (N=54, 15 clinics) from the prospective, BURST study (NCT05088265). Participants reported baseline demographics and completed adverse event surveys every 2 weeks. For A1C data, an at-home kit or electronic medical record was used for baseline and 3-month values; CGM metrics were collected post System initiation. Results: Most (85%) had T2D and median age was 57 years; 58% were Caucasian and 58% were female. Mean A1C decreased from 9.2±1.8% at baseline to 7.9±1.3% at 3 months (mean difference −1.2%, 95%CI −1.6 to −0.8, p<0.001). Four severe hypoglycemia events in 3 participants and 1 DKA occurred and were not related to the System. Percent time below range and other 3-month glycemic outcomes and System use data are shown (Table). Discussion: In this cohort, consisting primarily of older adults with T2D using MDI and suboptimal glycemic control, durable glycemic improvement occurred using Bigfoot Unity at 3 months. The observed reduction in A1C in this older cohort does not compromise them in meeting established hypoglycemia targets of <4 and <1% for percent time below 70 and 54 mg/dL, respectively. Disclosure J.K.Malone: Employee; Bigfoot Biomedical, Inc. R.Beck: Consultant; Eli Lilly and Company, Novo Nordisk, Diasome, Insulet Corporation, Research Support; Tandem Diabetes Care, Inc., Beta Bionics, Inc., Dexcom, Inc., Bigfoot Biomedical, Inc., Medtronic, Ascensia Diabetes Care, Roche Diabetes Care, Eli Lilly and Company, Novo Nordisk. J.Tillman: Employee; Bigfoot Biomedical, Inc. P.Calhoun: None. T.J.Mouse: None. R.Bailey: None. B.P.Olson: Employee; Bigfoot Biomedical, Inc. S.Vaughan: Employee; Bigfoot Biomedical, Inc. F.Sheikh: Employee; Bigfoot Biomedical, Inc. Funding Bigfoot Biomedical, Inc.
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The prospective 6-month study reported here showed similar results to 3-month data presented previously and similar glycemic control to a retrospective cohort using Bigfoot Unity.
“In general, the prospective 6-month study reported here showed similar results to 3-month data presented previously (35) and similar glycemic control to a retrospective cohort using Bigfoot Unity (34); here, the baseline HbA1c was higher (9.1% vs 8.4%), which may reflect health status or other demographic biases in those who consent to participate in an ongoing study vs those who do not (36).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [35]
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Diabetes Technology in People with Type 2 Diabetes: Novel Indications
Agarwal, S., Galindo, R. J., Shah, A. V., & Abreu, M. (2024) · Current Diabetes Reports · doi:10.1007/s11892-024-01536-4 · Cited by 12 · see citing works
“An interim analysis of this study showed that 85% of participants enrolled had T2D and mean A1C decreased from 9.2 ± 1.8% at baseline to 7.9 ± 1.3% at 3 months (mean difference − 1.2%, 95% CI − 1.6 to − 0.8, P 0.001) [36].”
InfluentialTillman, J. B., Beck, R. W., Polonsky, W. H., Calhoun, P., Mouse, T., Bailey, R., Jacoby, J., Nandan, R., Sheikh, F. N., & Malone, J. K. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae778 · Cited by 1 · see citing works
Self-citation
- Authors
- MALONE, J. K., BECK, R., TILLMAN, J., CALHOUN, P., MOUSE, T. J., BAILEY, R., OLSON, B. P., VAUGHAN, S., & NAUREEN SHEIKH, F.
- Affiliations
- Milpitas, CA, Tampa, FL
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2023-06-20
- Volume
- 72
- Issue
- Supplement_1
- ISSN
- 0012-1797 (ISSN-L)
- OpenAlex
- W4381378249
- Cited by
- 2
- References
- 0
- Citations by year
- 2024: 2
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- continuous glucose monitoring, type 2 diabetes, glycemic control, HbA1c reduction, older adults, multiple daily insulin injections, hypoglycemia, time below range, diabetes self-management, real-world data, diabetes support and education
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