Background and Aims

Background: carbohydrate (CHO) counting is often performed inaccurately by patients with type 1 diabetes (T1D). We hypothesized that mobile App “Dietrometro”, that estimates CHO content of food pictures and weights, would ameliorate glucose control in T1D subjects.

Aim: to study the effect of Dietometro on glucose control.

Methods

Methods: 60 T1D subjects (aged 18-60 years, 31 males), on multiple daily injections (n=26) or continuous subcutaneous insulin infusion (n=34), were randomly assigned to three groups: no CHO counting (group 1; n=21), “self-managed” counting (group 2; n=19) and App-assisted counting (group 3; n=20). Main outcomes were TIR at one-month and HbA1c at three-months follow-up. Time above (TAR) and below range (TBR) were estimated by flash (Freestyle Libre-1) or continuous glucose monitoring (Guardian, Dexcom G6).

Results

Results: Age, gender, type of insulin, glucose monitoring system and baseline TIR were similar between groups, while baseline HbA1c was lower in group 3 compared to group 1 (6.9±1.06 vs. 7.8±0.85%; p<0.05). At one-month follow-up, TIR was higher in group 3 compared to group 1 (66.53±14.71 vs. 54.38±14.23; p=0.02), but similar between other groups (p>0.11), although this difference disappeared after adjustment for baseline HbA1c. At three-months follow-up, groups 2 and 3 had a lower HbA1c than group 1 (7.17±0.86 vs. 6.88±1.05 vs. 8.18±1.06%, respectively; p=0.001). TAR and TBR were similar between groups at baseline and after one-month follow-up.

Conclusions

Conclusions: app-assisted CHO counting might improve TIR in T1D. Larger sample size and longer follow-up are needed to define the long-term effect of this system and its advantage over self-managed counting.