Using a Mobile App to Manage Type 1 Diabetes

2015 ◽  
Author(s):  
Francesco Miele ◽  
Claudio Eccher ◽  
Enrico Maria Piras
Keyword(s):  
Type 1 Diabetes ◽  
Mobile App

scholarly journals Experiences of Adults With Type 1 Diabetes Using Glucose Sensor–Based Mobile Technology for Glycemic Variability: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Marilyn D Ritholz ◽  
Owen Henn ◽  
Astrid Atakov Castillo ◽  
Howard Wolpert ◽  
Stephanie Edwards ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Qualitative Study ◽  
Mobile Technology ◽  
Glucose Sensor ◽  
Self Care ◽  
Glycemic Variability ◽  
Mobile App ◽  
Self Management ◽  
Freestyle Libre

BACKGROUND Adults with type 1 diabetes (PWDs) face challenging self-management regimens including monitoring their glucose values multiple times a day to assist with achieving glycemic targets and reduce the risk of long-term diabetes complications. Recent advances in diabetes technology have reportedly improved glycemia, but little is known about how PWDs utilize mobile technology to make positive changes in their diabetes self-management. OBJECTIVE The aim of this qualitative study was to explore PWDs’ experiences using Sugar Sleuth, a glucose sensor–based mobile app and Web-based reporting system, integrated with the FreeStyle Libre glucose monitor that provides feedback about glycemic variability. METHODS We used a qualitative descriptive research design and conducted semistructured interviews with 10 PWDs (baseline mean glycated hemoglobin, HbA1c) 8.0%, (SD 0.45); 6 males and 4 females, aged 52 years (SD 15), type 1 diabetes (T1D) duration 31 years (SD 13), 40% (4/10, insulin pump) following a 14-week intervention during which they received clinical support and used Sugar Sleuth to evaluate and understand their glucose data. Audio-recorded interviews were transcribed, coded, and analyzed using thematic analysis and NVivo 11 (QSR International Pty Ltd). RESULTS A total of 4 main themes emerged from the data. Participants perceived Sugar Sleuth as an Empowering Tool that served to inform lifestyle choices and diabetes self-management tasks, promoted preemptive self-care actions, and improved discussions with clinicians. They also described Sugar Sleuth as providing a Source of Psychosocial Support and offering relief from worry, reducing glycemic uncertainty, and supporting positive feelings about everyday life with diabetes. Participants varied in their Approaches to Glycemic Data: 40% (4/10) described using Sugar Sleuth to review data, understand glycemic cause and effect, and plan for future self-care. On the contrary, 60% (6/10) were reluctant to review past data; they described receiving benefits from the immediate numbers and trend arrows, but the app still prompted them to enter in the suspected causes of glucose excursions within hours of their occurrence. Finally, only 2 participants voiced Concerns About Use of Sugar Sleuth; they perceived the app as sometimes too demanding of information or as not attuned to the socioeconomic backgrounds of PWDs from diverse populations. CONCLUSIONS Results suggest that Sugar Sleuth can be an effective educational tool to enhance both patient-clinician collaboration and diabetes self-management. Findings also highlight the importance of exploring psychosocial and socioeconomic factors that may advance the understanding of PWDs’ individual differences when using glycemic technology and may promote the development of customized mobile tools to improve diabetes self-management.

scholarly journals Carbohydrate Counting App Using Image Recognition for Youth With Type 1 Diabetes: Pilot Randomized Control Trial

10.2196/22074 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e22074
Author(s):  
Jeffrey E Alfonsi ◽  
Elizabeth E Y Choi ◽  
Taha Arshad ◽  
Stacie-Ann S Sammott ◽  
Vanita Pais ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Digital Health ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Mobile App ◽  
Thinking Aloud ◽  
Carbohydrate Counting ◽  
Scale Scores

Background Carbohydrate counting is an important component of diabetes management, but it is challenging, often performed inaccurately, and can be a barrier to optimal diabetes management. iSpy is a novel mobile app that leverages machine learning to allow food identification through images and that was designed to assist youth with type 1 diabetes in counting carbohydrates. Objective Our objective was to test the app's usability and potential impact on carbohydrate counting accuracy. Methods Iterative usability testing (3 cycles) was conducted involving a total of 16 individuals aged 8.5-17.0 years with type 1 diabetes. Participants were provided a mobile device and asked to complete tasks using iSpy app features while thinking aloud. Errors were noted, acceptability was assessed, and refinement and retesting were performed across cycles. Subsequently, iSpy was evaluated in a pilot randomized controlled trial with 22 iSpy users and 22 usual care controls aged 10-17 years. Primary outcome was change in carbohydrate counting ability over 3 months. Secondary outcomes included levels of engagement and acceptability. Change in HbA1c level was also assessed. Results Use of iSpy was associated with improved carbohydrate counting accuracy (total grams per meal, P=.008), reduced frequency of individual counting errors greater than 10 g (P=.047), and lower HbA1c levels (P=.03). Qualitative interviews and acceptability scale scores were positive. No major technical challenges were identified. Moreover, 43% (9/21) of iSpy participants were still engaged, with usage at least once every 2 weeks, at the end of the study. Conclusions Our results provide evidence of efficacy and high acceptability of a novel carbohydrate counting app, supporting the advancement of digital health apps for diabetes care among youth with type 1 diabetes. Further testing is needed, but iSpy may be a useful adjunct to traditional diabetes management. Trial Registration ClinicalTrials.gov NCT04354142; https://clinicaltrials.gov/ct2/show/NCT04354142

scholarly journals One Drop App With an Activity Tracker for Adults With Type 1 Diabetes: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Chandra Y Osborn ◽  
Ashley Hirsch ◽  
Lindsay E Sears ◽  
Mark Heyman ◽  
Jennifer Raymond ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Type 1 Diabetes ◽  
Controlled Trial ◽  
Mobile App ◽  
Analysis Of Covariance ◽  
Activity Tracker ◽  
Randomized Controlled ◽  
Hemoglobin A ◽  
The One

BACKGROUND In 2017, mobile app support for managing diabetes was available to 64% of the global population of adults with diabetes. One Drop’s digital therapeutics solution includes an evidence-based mobile app with global reach, a Bluetooth-connected glucometer, and in-app coaching from Certified Diabetes Educators. Among people with type 1 diabetes and an estimated hemoglobin A<sub>1c</sub> level≥7.5%, using One Drop for 3 months has been associated with an improved estimated hemoglobin A<sub>1c</sub> level of 22.2 mg/dL (–0.80%). However, the added value of integrated activity trackers is unknown. OBJECTIVE We conducted a pragmatic, remotely administered randomized controlled trial to evaluate One Drop with a new-to-market activity tracker against One Drop only on the 3-month hemoglobin A<sub>1c</sub> level of adults with type 1 diabetes. METHODS Social media advertisements and online newsletters were used to recruit adults (≥18 years old) diagnosed (≥1 year) with T1D, naïve to One Drop’s full solution and the activity tracker, with a laboratory hemoglobin A<sub>1c</sub> level≥7%. Participants (N=99) were randomized to receive One Drop and the activity tracker or One Drop only at the start of the study. The One Drop only group received the activity tracker at the end of the study. Multiple imputation, performed separately by group, was used to correct for missing data. Analysis of covariance models, controlling for baseline hemoglobin A<sub>1c</sub>, were used to evaluate 3-month hemoglobin A<sub>1c</sub> differences in intent-to-treat (ITT) and per protocol (PP) analyses. RESULTS The enrolled sample (N=95) had a mean age of 41 (SD 11) years, was 73% female, 88% White, diagnosed for a mean of 20 (SD 11) years, and had a mean hemoglobin A<sub>1c</sub> level of 8.4% (SD 1.2%); 11% of the participants did not complete follow up. Analysis of covariance assumptions were met for the ITT and PP models. In ITT analysis, participants in the One Drop and activity tracker condition had a significantly lower 3-month hemoglobin A<sub>1c</sub> level (mean 7.9%, SD 0.60%, 95% CI 7.8-8.2) than that of the participants in the One Drop only condition (mean 8.4%, SD 0.62%, 95% CI 8.2-8.5). In PP analysis, participants in the One Drop and activity tracker condition also had a significantly lower 3-month hemoglobin A<sub>1c</sub> level (mean 7.9%, SD 0.59%, 95% CI 7.7-8.1) than that of participants in the One Drop only condition (mean 8.2%, SD 0.58%, 95% CI 8.0-8.4). CONCLUSIONS Participants exposed to One Drop and the activity tracker for the 3-month study period had a significantly lower 3-month hemoglobin A<sub>1c</sub> level compared to that of participants exposed to One Drop only during the same timeframe. One Drop and a tracker may work better together than alone in helping people with type 1 diabetes. CLINICALTRIAL ClinicalTrials.gov NCT03459573; https://clinicaltrials.gov/ct2/show/NCT03459573.

scholarly journals Using an mHealth App to Transition Care of Type 1 Diabetes from Parents to Teens: Protocol for a Pilot Study (Preprint)

2018 ◽  
Author(s):  
Bree E Holtz ◽  
Katharine M Mitchell ◽  
Denise D Hershey ◽  
Shelia R Cotten ◽  
Amanda J Holmstrom ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
The United States ◽  
Mobile App ◽  
Self Management ◽  
Pilot Test ◽  
Pilot Testing ◽  
App Development ◽  
Difficult Time ◽  
Two Phases

BACKGROUND Type 1 diabetes mellitus (T1DM) afflicts approximately 154,000 people under the age of 20 in the United States. Most people with T1DM are diagnosed at a young age, and parents have to take on the responsibility of T1DM management. Eventually, the child must begin to transition to self-management. Adolescents often struggle to take on responsibility for all the necessary tasks to successfully self-manage their T1DM. In fact, approximately three-quarters of adolescents are not achieving American Diabetes Association–recommended glycated hemoglobin (HbA1c) targets. This lack of adherence can lead to negative health outcomes. OBJECTIVE The goals of this interdisciplinary proposal are as follows: (1) to develop a unique and theory-driven technology using a mobile phone app to promote self-management behaviors for adolescents aged 10-15 years with T1DM and their parents and (2) to explore the feasibility and impact of the self-management mobile app. METHODS This study has two phases: app development and pilot testing. In the app development phase, the app will be conceptualized and a prototype will be tested. In Phase 2, the mobile app will undergo pilot testing to determine its feasibility and impact on diabetes self-management. RESULTS The pilot test was launched in September 2017. Data collection for the final pilot test is underway, and results are forthcoming. CONCLUSIONS Adolescents with T1DM and their parents can have a difficult time managing the transition of diabetes care. It is hoped that this app can help. The focus groups and prototype testing have indicated promising outcomes of app use. CLINICALTRIAL ClinicalTrials.gov NCT03436628; https://clinicaltrials.gov/ct2/show/NCT03436628 (Archived by WebCite at http://www.webcitation.org/72tHXTE2Z) INTERNATIONAL REGISTERED REPOR RR1-10.2196/10803

scholarly journals A Mobile App for the Self-Management of Type 1 Diabetes Among Adolescents: A Randomized Controlled Trial

2017 ◽  
Vol 5 (6) ◽  
pp. e82 ◽  
Author(s):  
Shivani Goyal ◽  
Caitlin A Nunn ◽  
Michael Rotondi ◽  
Amy B Couperthwaite ◽  
Sally Reiser ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Type 1 Diabetes ◽  
Controlled Trial ◽  
Mobile App ◽  
The Self ◽  
Self Management ◽  
Randomized Controlled

scholarly journals Exploration of Users’ Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study

10.2196/11400 ◽  
2018 ◽  
Vol 6 (9) ◽  
pp. e11400 ◽  
Author(s):  
Yiyu Zhang ◽  
Xia Li ◽  
Shuoming Luo ◽  
Chaoyuan Liu ◽  
Fang Liu ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Mixed Methods ◽  
Diabetes Management ◽  
Mobile App ◽  
Mixed Methods Study

scholarly journals Evaluating a Glucose-Sensor-Based Tool to Help Clinicians and Adults With Type 1 Diabetes Improve Self-Management Skills

2018 ◽  
Vol 12 (6) ◽  
pp. 1143-1151 ◽  
Author(s):  
Elena Toschi ◽  
Lawrence Fisher ◽  
Howard Wolpert ◽  
Michael Love ◽  
Timothy Dunn ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Rating Scales ◽  
Glucose Sensor ◽  
Self Care ◽  
Mobile App ◽  
Self Management ◽  
Management Skills ◽  
Motivation To Change ◽  
Freestyle Libre

Background: The goal of this uncontrolled pilot study was to assess the feasibility of a self-care management mobile app, called Sugar Sleuth, which incorporates the FreeStyle Libre™ glucose sensor, to help clinicians and people with type 1 diabetes (PWD) identify and mitigate self-care behaviors that contribute to glucose variability. Methods: PWDs with a baseline A1c between 7.5 and 9.0% used the mobile app for 14 weeks. The app prompted the PWD to enter the suspected cause of detected glycemic excursions, and to record food and insulin information. PWDs met with clinicians to collaboratively review data, identify challenges, and devise a specific self-care plan. Outcome measures included a single glycemic outcome score (SGOS) and attitude rating scales to better understand how participant attitudes could affect glycemic outcome. Results: Thirty enrolled PWDs had a mean age of 55 ± 2.6 years, and a mean diabetes duration of 32 ± 2.9 years. A significant average reduction in A1c of 0.5 ± 0.07% ( P < .01) and in mean daily carbohydrate intake of 43 ± 21 grams ( P = .05) was found. No statistically significant change in glycemic metrics, body weight, or total daily insulin dose was found. A significant negative association occurred between SGOS and “hypoglycemia tolerance” ( P = .04), and a positive correlation occurred that approached significance with “motivation to change behavior” ( P = .06). Conclusions: These findings suggest that this mobile app system, in conjunction with CGM, provides a useful platform for helping clinicians and adults with T1D improve self-management skills to improve glycemic control.

MyT1DHero, an mHealth-Based Intervention, For Adolescents with Type 1 Diabetes and Their Parents: A Pilot Study (Preprint)

2020 ◽  
Author(s):  
Bree E Holtz ◽  
Katharine M Mitchen ◽  
Amanda J Holmstrom ◽  
Shelia R Cotten ◽  
Julie K Dunneback ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Pilot Study ◽  
Controlled Trial ◽  
Final Analysis ◽  
The United States ◽  
Mobile App ◽  
The Stability

BACKGROUND Type 1 diabetes (T1D) impacts more than 165,000 individuals under the age of 20 in the United States. The transition from parent management to parent-child team management, with the child taking on increased levels of self-care, can be stressful and is associated with a deterioration in self-management behaviors. A mobile app intervention, MyT1DHero was designed to facilitate diabetes specific positive parent-adolescent communication. OBJECTIVE To conduct a pilot test to determine the efficacy of the MyT1DHero app intervention. METHODS This pilot study included 30 adolescent-parent pairs in a 12-week single arm clinical trial. RESULTS The final analysis included 25 families. The mean age of the adolescents was 12.281.62 years old. Half of the participants reported a diagnosis of fewer than five years. After 12-weeks, diabetes adherence significantly improved (P=.02) as did quality of life (P=0.01). HbA1c level (P=.51) and family conflict (P=0.14) changed in the hypothesized direction, but the change was not significant. However, higher use of the mobile app was associated with more improvement in HbA1c, (F(1, 20)=9.74, P<.01, R2=.33). Overall, the adolescents were satisfied with app intervention. CONCLUSIONS In a 12-week pilot study of the mobile app intervention designed to facilitate parent-adolescent communication, significant benefits were demonstrated in adherence and quality of life. A randomized controlled trial with a longer intervention is needed to replicate these findings and determine the stability of intervention effects. CLINICALTRIAL NCT03436628

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