Carbohydrate Counting/Bolus Calculator Mobile Application Improves Time in Range in Adults with Type 1 Diabetes Subjects.

Abstract

Objective: To evaluate the effectiveness and safety of a mobile application for carbohydrate counting and bolus calculation (CHOC-BC) in adults with type 1 diabetes mellitus (T1DM). Research Design and Methods: A 12-week randomized controlled trial was conducted at King Fahad Medical City, Riyadh, Saudi Arabia. Adults with T1DM on multiple daily insulin injections and using Libre 2 glucose monitors were randomized to either CHOC-BC or conventional treatment. The primary endpoint was time in range (TIR; 70-180 mg/dL). Results: A total of 127 participants (70 females) were included: 64 in the intervention group and 63 in the control group with a mean age of 26.56 ± 4.8 and 26.74 ± 6.52 years, respectively. After 3 months, the intervention group achieved better TIR than the control group (51.20% ± 11.61% vs. 46.17% ± 13.02%; mean difference [MD], 5.03; 95% confidence interval [CI], 0.70-9.36; P = 0.023). Application users showed a significant reduction in level 2 time above range (17.25% ± 11.61% vs. 24.10% ± 15.74%; MD, -6.85; 95% CI, -11.70 to -1.99; P = 0.006). No significant differences were observed in body weight or time below range. Conclusions: The CHOC-BC mobile application empowered users to achieve better glycemic control while maintaining a safe profile that avoids hypoglycemia and weight gain.