OptimAAPP, a smartphone insulin dose calculator for carbohydrate, fat, and protein: A cross-over, randomised controlled trial in adolescents and adults with type 1 diabetes using multiple daily injection therapy.

IF 3.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Tenele A Smith, Nisha Venkatesh, Kerryn Roem, Jean C Lu, Emma Netzer, Adrian Medioli, Stuart Szwec, David N O'Neal, Bruce R King, Carmel E Smart
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引用次数: 0

Abstract

Aims: To (1) evaluate the efficacy of OptimAAPP, a smartphone insulin dose calculator for carbohydrate, fat, and protein in managing glycaemia compared with carbohydrate counting in adolescents and adults with type 1 diabetes using flexible multiple daily injection therapy (MDI, ≥4 injections/day) and (2) assess user acceptability of OptimAAPP.

Methods: In this free-living trial, participants aged 12-50 years were randomised to use carbohydrate counting or OptimAAPP for meal insulin dose calculation for 3 months, then use the alternate method for 3 months. The primary outcome, time-in-range (3.9-10.0 mmol/L) was measured in weeks 3-4 of each arm using continuous glucose monitoring. The acceptability of OptimAAPP was assessed at end intervention using a purpose-designed questionnaire.

Results: An intention-to-treat analysis of 41 participants, mean age 28 ± 12 years and HbA1c 56 ± 10 mmol/mol (7.3 ± 0.9%) found no significant difference in glycaemic outcomes when using OptimAAPP compared with carbohydrate counting including time-in-range (70.5 vs. 67.6%, p = 0.102), above range (24.5% vs. 28.0%, p = 0.068), below range (4.9% vs. 4.4%, p = 0.318), and coefficient of variation (32.2% vs. 33.3%, p = 0.136). There was no severe hypoglycaemia. Participants reported that OptimAAPP was easy to use (79%), and they were confident in giving the recommended doses (82%). Barriers to use were the small food database and the time associated with food entry.

Conclusions: In adolescents and adults using flexible MDI therapy, OptimAAPP use did not produce glycaemic outcomes that were significantly different from carbohydrate counting. Participant views of OptimAAPP indicate a high level of acceptability. Increasing the size of the food database will likely enhance the user experience.

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来源期刊
Diabetic Medicine
Diabetic Medicine 医学-内分泌学与代谢
CiteScore
7.20
自引率
5.70%
发文量
229
审稿时长
3-6 weeks
期刊介绍: Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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