title: Improved A1C Levels in Type 1 Diabetes with Smartphone App Use.
abstract: OBJECTIVE
  Smartphones are a potentially useful tool in diabetes care. We have developed an application (app) linked to a website, Intelligent Diabetes Management (IDM), which serves as both an insulin bolus calculator and an electronic diabetes diary. We have prospectively studied whether patients using this app improved control of their glucose levels.
  
  
  METHODS
  Patients with type 1 diabetes were recruited. There was a 4-week observation period, midway during which we offered to review the participants' records. The app was then downloaded and participants' diabetes regimens entered on the synchronized IDM website. At 2, 4, 8, 12 and 16 weeks of the active phase, their records were reviewed online, and feedback was provided electronically. The primary endpoint was change in levels of glycated hemoglobin (A1C).
  
  
  RESULTS
  Of the 31 patients recruited, 18 completed the study. These 18 made 572±98 entries per person on the IDM system over the course of the study (≈5.1/day). Their ages were 40.0±13.9 years, the durations of their diabetes were 27.3±14.9 years and 44% used insulin pumps. The median A1C level fell from 8.1% (7.5 to 9.0, IQ range) to 7.8% (6.9 to 8.3; p<0.001). During the observation period, glucose records were reviewed for 50% of the participants. In the active phase, review of the glucose diaries took less time on the IDM website than using personal glucose records in the observation period, median 6 minutes (5 to 7.5 IQ range) vs. 10 minutes (7.5 to 10.5 IQ range; p<0.05).
  
  
  CONCLUSIONS
  Our smartphone app enables online review of glucose records, requires less time for clinical staff and is associated with improved glucose control.
authors: Divisions of Endocrinology and Metabolism and Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada. Electronic address: edmond.ryan@ualberta.ca.
authors: Edmond A
authors: EA
authors: Ryan
authors: Divisions of Endocrinology and Metabolism and Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
authors: Joanna
authors: J
authors: Holland
authors: Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada.
authors: Eleni
authors: E
authors: Stroulia
authors: Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada.
authors: Blerina
authors: B
authors: Bazelli
authors: Divisions of Endocrinology and Metabolism and Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
authors: Stephanie A
authors: SA
authors: Babwik
authors: Alberta Innovates Centre for Machine Learning, University of Alberta, Edmonton, Alberta, Canada.
authors: Haipeng
authors: H
authors: Li
authors: Divisions of Endocrinology and Metabolism and Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
authors: Peter
authors: P
authors: Senior
authors: Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada; Alberta Innovates Centre for Machine Learning, University of Alberta, Edmonton, Alberta, Canada.
authors: Russ
authors: R
authors: Greiner
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications / Q000706:statistics & numerical data* / Q000639:trends; D000068997:Smartphone / Q000706:statistics & numerical data* / Q000639:trends; D017216:Telemedicine / Q000706:statistics & numerical data* / Q000639:trends
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: ajustement de l'insuline; app; appli; bolus calculator; calculateur de bolus; diabète de type 1; glucose control; insulin adjustment; régulation de la glycémie; smartphone; type 1 diabetes; téléphone intelligent