Diabetes Interactive Diary: A New Telemedicine System Enabling Flexible Diet and Insulin Therapy While Improving Quality of Life
Open accessAbstract
OBJECTIVE: Widespread use of carbohydrate counting is limited by its complex education. In this study we compared a Diabetes Interactive Diary (DID) with standard carbohydrate counting in terms of metabolic and weight control, time required for education, quality of life, and treatment satisfaction. RESEARCH DESIGN AND METHODS: Adults with type 1 diabetes were randomly assigned to DID (group A, n = 67) or standard education (group B, n = 63) and followed for 6 months. A subgroup also completed the SF-36 Health Survey (SF-36) and World Health Organization-Diabetes Treatment Satisfaction Questionnaire (WHO-DTSQ) at each visit. RESULTS: Of 130 patients (aged 35.7 +/- 9.4 years; diabetes duration 16.5 +/- 10.5 years), 11 dropped out. Time for education was 6 h (range 2-15 h) in group A and 12 h (2.5-25 h) in group B (P = 0.07). A1C reduction was similar in both groups (group A from 8.2 +/- 0.8 to 7.8 +/- 0.8% and group B from 8.4 +/- 0.7 to 7.9 +/- 1.1%; P = 0.68). Nonsignificant differences in favor of group A were documented for fasting blood glucose and body weight. No severe hypoglycemic episode occurred. WHO-DTSQ scores increased significantly more in group A (from 26.7 +/- 4.4 to 30.3 +/- 4.5) than in group B (from 27.5 +/- 4.8 to 28.6 +/- 5.1) (P = 0.04). Role Physical, General Health, Vitality, and Role Emotional SF-36 scores improved significantly more in group A than in group B. CONCLUSIONS: DID is at least as effective as traditional carbohydrate counting education, allowing dietary freedom for a larger proportion of type 1 diabetic patients. DID is safe, requires less time for education, and is associated with lower weight gain. DID significantly improved treatment satisfaction and several quality-of-life dimensions.
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For individuals with type 1 diabetes, intensive insulin therapy using the carbohydrate counting approach can result in improved glycemia.
“For individuals with type 1 diabetes, intensive insulin therapy using the carbohydrate counting approach can result in improved glycemia and is recommended.”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [266]
Education on using insulin-to-carbohydrate ratios for meal planning can assist individuals with effectively modifying insulin dosing from meal to meal to improve glycemic management.
“In addition, education on using insulin-to-carbohydrate ratios for meal planning can assist individuals with effectively modifying insulin dosing from meal to meal to improve glycemic management (97,156,(180)(181)(182)(183).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [180]
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Self-citation
- Authors
- Rossi, M. C. E., Nicolucci, A., Di Bartolo, P., Bruttomesso, D., Girelli, A., Ampudia, F. J., Kerr, D., Ceriello, A., Mayor, C. D. L. Q., Pellegrini, F., Horwitz, D., & Vespasiani, G.
- Affiliations
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro (CH), Italy;
- Diabetes Unit, Presidio Ospedaliero, Ravenna, Italy;
- University of Padua (IT)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Unit of Endocrinology, Hospital Clínico Universitario, Valencia, Spain;
- Bournemouth University (GB)
- University of Warwick (GB)
- Unit of Endocrinology, Hospital Universitario Virgen Macarena, Sevilla, Spain;
- Medical and Clinical Affairs, LifeScan, Milpitas, California;
- Diabetes Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto (AP), Italy.
- Corresponding author
- Rossi, Maria C.E.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-10-06
- Volume
- 33
- Issue
- 1
- Pages
- 109-115
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2797954
- OpenAlex
- W2158685862
- Cited by
- 174
- References
- 22
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 13 · 2023: 3 · 2022: 5 · 2021: 12 · 2020: 12 · 2019: 15 · 2018: 15 · 2017: 14 · 2016: 14 · 2015: 9 · 2014: 14 · 2013: 18 · 2012: 6
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- 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 › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- type 1 diabetes, carbohydrate counting, diabetes education, telemedicine, insulin therapy, dietary flexibility, quality of life, treatment satisfaction, glycemic control, weight gain, hypoglycemia
- MeSH terms
- Adult, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Quality of Life, Treatment Outcome
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