title: Development of a Smartphone Application to Capture Carbohydrate, Lipid, and Protein Contents of Daily Food: Need for Integration in Artificial Pancreas for Patients With Type 1 Diabetes?
abstract: BACKGROUND
  Meal lipids (LIP) and proteins (PRO) may influence the effect of insulin doses based on carbohydrate (CHO) counting in patients with type 1 diabetes (T1D). We developed a smartphone application for CHO, LIP, and PRO counting in daily food and assessed its usability in real-life conditions and potential usefulness.
  
  
  METHODS
  Ten T1D patients used the android application for 1 week to collect their food intakes. Data included meal composition, premeal and 2-hour postmeal blood glucose, corrections for hypo- or hyperglycemia after meals, and time for entering meals in the application. Meal insulin doses were based on patients' CHO counting (application in blinded mode). Linear mixed models were used to assess the statistical differences.
  
  
  RESULTS
  In all, 187 meals were analyzed. Average computed CHO amount was 74.37 ± 31.78 grams; LIP amount: 20.26 ± 14.28 grams and PRO amount: 25.68 ± 16.68 grams. Average CHO, LIP, and PRO contents were significantly different between breakfast and lunch/dinner. The average time for meal entry in the application moved from 3-4 minutes to 2.5 minutes during the week. No significant impact of LIP and PRO was found on available blood glucose values.
  
  
  CONCLUSIONS
  Our study shows CHO, LIP, and PRO intakes can be easily captured by an application on smartphone for meal entry used by T1D patients. Although LIP and PRO meal contents did not influence glucose levels when insulin doses were based on CHO in this pilot study, this application could be used for further investigation of this topic, including in closed-loop conditions.
authors.affiliation: Institute of Functional Genomics, CNRS UMR 5203, INSERM U1191, University of Montpellier, Montpellier, France.
authors.forename: Omar
authors.initials: O
authors.lastname: Diouri
authors.affiliation: Institute of Functional Genomics, CNRS UMR 5203, INSERM U1191, University of Montpellier, Montpellier, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Place
authors.affiliation: Montpellier University Hospital, Department of Endocrinology, Diabetes, Nutrition, Montpellier, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Traverso
authors.affiliation: Montpellier University Hospital, Department of Medical Information, Unit of Clinical and Epidemiological Research, Montpellier, France.
authors.forename: Vera
authors.initials: V
authors.lastname: Georgescu
authors.affiliation: Montpellier University Hospital, Department of Medical Information, Unit of Clinical and Epidemiological Research, Montpellier, France INSERM Clinical Investigation Centre 1411, Montpellier, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Picot
authors.affiliation: Institute of Functional Genomics, CNRS UMR 5203, INSERM U1191, University of Montpellier, Montpellier, France Montpellier University Hospital, Department of Endocrinology, Diabetes, Nutrition, Montpellier, France Montpellier University Hospital, Department of Medical Information, Unit of Clinical and Epidemiological Research, Montpellier, France e-renard@chu-montpellier.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: Renard
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy*; D003927:Diet, Diabetic; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage*; D004867:Equipment Design; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D019397:Pancreas, Artificial; D010865:Pilot Projects; D000068997:Smartphone; D012985:Software Design; D012986:Software Validation; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: carbohydrates; glucose control; lipids; proteins; smartphone application; type 1 diabetes