Providers | Hygieia

What is the d-Nav® Insulin Management Program?

The d-Nav® Insulin Management Program is a specialty service designed to support you in providing care to a small, but very challenging segment of your patients. Namely patients with long-term type 2 diabetes relying on insulin therapy. Learn more about the d-Nav way here.

“One of our offices reported an amazing Hygieia story to us this week. The office has a very non-compliant patient who was seen 11/18/2016 with A1C of 15.7. She was started on the Hygieia program after that visit. She was seen on 3/6/2017 and her A1C was 6.4!!! We thought you might want to know some of the major success stories reported to us as a result of Hygieia.”

Melissa Kirshner, Executive Director, Olympia Medical LLC



Your time is valuable

Glycemic Control of Insulin Treated Patients Across the U.S: Epidemiologic Analysis of a Commercially Insured Population. Chen et al. American Diabetes Association Meeting. 2013;2765-PO

Studies indicate that two-thirds of patients on insulin are not achieving glycemic control despite your team’s best efforts.

Information from insulin manufacturers, as well as clinical studies, clearly indicate that effective insulin therapy requires dose titration every 3-7 days. The large number of insulin types commercially available adds another level of complexity in treating patients with advanced type 2 diabetes. The result is that this relatively small segment of your practice consumes a disproportionate amount of your team’s clinical time without significant success.



Research Shows a Better Way


Research suggests that automatic insulin titration through our d-Nav® Insulin Management Program can achieve significantly improved outcomes while reducing the frequency of hypoglycemia.

The d-Nav® Program consists of an FDA-cleared app that has been thoroughly tested, reviewed, and used internationally. This technology sits on a handheld device that uploads information to the cloud and based on the current glucose reading and patient historical data, makes an insulin dose recommendation before each injection.




HbA1c for d-Nav Insulin Program Management Users
d-Nav® Program Clinical Outcomes Since 2013

The d-Nav® Program has been well studied and results of a multi-site randomized, controlled clinical study have been published by The Lancet. The d-Nav® Program was reviewed in the journal of Clinical Diabetes and Endocrinology. Nearly 90% of patients experienced a reduction in A1C in just three months.

In addition, a study published in Diabetes Technologies and Therapeutics demonstrated that changes in insulin requirements are a significant source of hypoglycemia. The frequency of severe hypoglycemia for patients using d-Nav is half the rate of the norm. d-Nav patients experience 2.5 hypo events per 100 patient-years, as compared to the norm with 4-5 events per 100 patient-years.



What are the benefits to my practice?

We welcod-Nav Herbert Isaac MDme adult patients with type 2 diabetes who are using insulin to treat their type 2 diabetes and have an A1C above the treatment goal.

When you refer a patient to Hygieia, our Certified Diabetes Care and Education Specialists will reach out to your patient and invite them to begin the d-Nav® Insulin Management Program.

Your office will have the ability to track all the interactions we have with any of your patients through our secure physician portal. You will have access to simple progress reports as well as more detailed reports for each of your patients.



Please refer patients who you feel may benefit from the program by faxing the patient information to 734-469-5082, or by calling 734-743-2838.


What is the science behind frequent insulin titration?

Dozens of studies have demonstrated that effective insulin treatment requires dose adjustment on a weekly basis. This is because patients’ insulin requirements can vary significantly over time.

A recent study showed most patients go through periods that average 10 weeks in length where their insulin requirements will go down by an average of 40%. This means a patient might be taking 100 insulin units per day but need only 60 units – which often leads to hypoglycemia. Such a period occurs roughly every 15 months.

d-Nav® titration
Digitally Enhanced Insulin Therapy—A Multicenter Clinical Trial, Diabetes 2018 Jul; 67 (Supplement 1): 353-OR.


Frequent titration of insulin doses, often on a weekly basis, is the only way to improve treatment safety and efficacy.

To talk to our Cheif Medical Officer, or to schedule an orientation to the d-Nav® Insulin Management Program please call 734-369-9984 or contact us using the button below.