Interactive Diary for Diabetes: A Useful and Easy-to-Use New Telemedicine System to Support the Decision-Making Process in Type 1 Diabetes
Abstract
BACKGROUND: Widespread use of carbohydrate (CHO) counting is limited by its complex educational needs, but a telemedicine system could simplify the patients' training. METHODS: The Diabetes Interactive Diary (DID) was set up on patients' mobile phones and allowed to record the blood glucose values and quantify the total CHO intake during a meal, by choosing the specific food and the amount ingested from a list of pictures. It also suggested the most appropriate insulin bolus in relation to the patient's CHO/insulin ratio. Data were sent to the physician by Short Message Service (also known as text message). Two pilot studies were carried out to investigate the feasibility and acceptability of the system and its effectiveness in improving metabolic control. RESULTS: In the first study, 50 patients were involved in a survey with questionnaires administered before and 12 weeks after the start of the DID. The system was considered by almost all the patients as easy to use and very helpful. CHO counting and insulin bolus calculation were ranked as the most useful functions. In the second study, 41 consecutive patients using DID under routine clinical practice conditions were evaluated after a median of 9 months of follow-up. DID was associated with a nonstatistically significant reduction in fasting blood glucose (FBG), postprandial glucose (PPG), and hemoglobin A1c levels. FBG and PPG coefficient of variation (CV) values were significantly reduced: FBG-CV decreased by 6.7% (95% confidence interval -11.9, -1.6; P = 0.02), while PPG-CV decreased by 11.5% (95% confidence interval -19.3, -3.7; P = 0.01). No patients reported serious hypoglycemic episodes requiring medical intervention. CONCLUSIONS: DID can represent a useful, safe, and easy-to-use tool to help the patient with type 1 diabetes promote dietary freedom. Adjustment of insulin doses according to CHO intake allowed the reduction of glucose variability, increasingly recognized as an important, independent risk factor for cardiovascular events.
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Of the 27 papers, 7 focused on T1DM, with 308 patients in the intervention groups and 129 in the control groups.
“Of the 27 papers, 7 were focused on T1DM (308 patients in the intervention groups and 129 patients in the control groups) [43-49]”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [49]
Fasting blood glucose was reported in 1 T1DM study (41 patients), but a significant change was not found (P=.09).
“Fasting blood glucose was reported in 1 study (41 patients [49]), but a significant change was not found (P=.09).”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [49]
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- Authors
- Rossi, M. C. E., Nicolucci, A., Pellegrini, F., Bruttomesso, D., Bartolo, P. D., Marelli, G., Dal Pos, M., Galetta, M., Horwitz, D., & Vespasiani, G.
- Affiliations
- Mario Negri Sud Foundation (IT)
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbarco (CH), Italy.
- University of Padua (IT)
- Ospedale "Santa Maria delle Croci" di Ravenna (IT)
- Azienda Ospedaliera di Desio e Vimercate (IT)
- Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario, Padova, Italy.
- Servizio di Diabetologia, Ospedale Madonna del Soccorso, San Benedetto del Tronto (AP), Italy.
- Medical & Clinical Affairs, LifeScan, Inc., Milpitas, California.
- ORCID
- Venue
- Diabetes Technology & Therapeutics
- Publisher
- SAGE Publications
- Published
- 2009-01
- Volume
- 11
- Issue
- 1
- Pages
- 19-24
- ISSN
- 1520-9156 (ISSN-L)
- 1557-8593
- OpenAlex
- W2093460604
- Cited by
- 69
- References
- 28
- Citations by year
- 2026: 3 · 2024: 1 · 2023: 3 · 2022: 3 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 6 · 2016: 10 · 2015: 4 · 2014: 6 · 2013: 5 · 2012: 4
- FWCI
- 4.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Technology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 1 diabetes, carbohydrate counting, mobile application, telemedicine, glycemic variability, blood glucose monitoring, HbA1c, insulin dose adjustment, hypoglycemia, patient acceptability
- MeSH terms
- Adult, Diabetes Mellitus, Type 1, Dietary Carbohydrates, Female, Humans, Insulin, Male, Patient Education as Topic, Surveys and Questionnaires, Self Care, Telemedicine, Monitoring, Ambulatory, Young Adult
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