title: Training of carbohydrate estimation for people with diabetes using mobile augmented reality.
abstract: BACKGROUND
  Imprecise carbohydrate counting as a measure to guide the treatment of diabetes may be a source of errors resulting in problems in glycemic control. Exact measurements can be tedious, leading most patients to estimate their carbohydrate intake. In the presented pilot study a smartphone application (BE(AR)), that guides the estimation of the amounts of carbohydrates, was used by a group of diabetic patients.
  
  
  METHODS
  Eight adult patients with diabetes mellitus type 1 were recruited for the study. At the beginning of the study patients were introduced to BE(AR) in sessions lasting 45 minutes per patient. Patients redraw the real food in 3D on the smartphone screen. Based on a selected food type and the 3D form created using BE(AR) an estimation of carbohydrate content is calculated. Patients were supplied with the application on their personal smartphone or a loaner device and were instructed to use the application in real-world context during the study period. For evaluation purpose a test measuring carbohydrate estimation quality was designed and performed at the beginning and the end of the study.
  
  
  RESULTS
  In 44% of the estimations performed at the end of the study the error reduced by at least 6 grams of carbohydrate. This improvement occurred albeit several problems with the usage of BE(AR) were reported.
  
  
  CONCLUSIONS
  Despite user interaction problems in this group of patients the provided intervention resulted in a reduction in the absolute error of carbohydrate estimation. Intervention with smartphone applications to assist carbohydrate counting apparently results in more accurate estimations.
authors.affiliation: Department of MultiMediaTechnology, Salzburg University of Applied Sciences, Puch, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Domhardt
authors.affiliation: Department of MultiMediaTechnology, Salzburg University of Applied Sciences, Puch, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Tiefengrabner
authors.affiliation: Department of MultiMediaTechnology, Salzburg University of Applied Sciences, Puch, Austria.
authors.forename: Radomir
authors.initials: R
authors.lastname: Dinic
authors.affiliation: Department of Biomedical Sciences, Salzburg University of Applied Sciences, Puch, Austria.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Fötschl
authors.affiliation: Department of Biomedical Sciences, Salzburg University of Applied Sciences, Puch, Austria.
authors.forename: Gertie J
authors.initials: GJ
authors.lastname: Oostingh
authors.affiliation: Department of MultiMediaTechnology, Salzburg University of Applied Sciences, Puch, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Stütz
authors.affiliation: First Department of Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Lars
authors.initials: L
authors.lastname: Stechemesser
authors.affiliation: Department of Internal Medicine, Diakonissen Hospital Salzburg, Salzburg, Austria First Department of Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Raimund
authors.initials: R
authors.lastname: Weitgasser
authors.affiliation: Department of MultiMediaTechnology, Salzburg University of Applied Sciences, Puch, Austria simon.ginzinger@fh-salzburg.ac.at.
authors.forename: Simon W
authors.initials: SW
authors.lastname: Ginzinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose; D040421:Cell Phone; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy*; D003927:Diet, Diabetic; D004040:Dietary Carbohydrates; D004435:Eating; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D010865:Pilot Projects; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014584:User-Computer Interface; D014796:Visual Perception; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates
keywords: augmented reality; carbohydrate counting; diabetes education; mHealth