Bridging the Gap in Carbohydrate Counting with A Mobile Application: A Needs Assessment survey. (Preprint)

Abstract

Carbohydrate counting (CC) can be burdensome and difficulty with adherence have been reported. Automated CC through mobile applications offers innovative solutions to ease this burden.

A cross-sectional online survey was conducted to identify 1) perceived barriers to CC by Canadians living with type 1 diabetes (T1D), and 2) app-features that would help reduce these barriers. As a secondary objective, apps being used by participants were compared with the suggested app-features.

Participants completed a 39-closed- and open-ended question online survey to identify barriers in CC, preferred CC app-features, and current CC app use. Respondents rated the importance of barriers and proposed app-features using a 5-point Likert scale.

Participants (n=196: 74% women, mean age 40±17 years, mean diabetes duration 22±14 years, 91% relied on CC to determine insulin doses at mealtimes) reported carbohydrate identification barriers, nutrient interaction and insulin dose calculation barriers, as well as psychosocial barriers. App-feature preferences emphasized the need for features for nutrient analysis (84%), personalization of the app (77%), insulin bolus calculation (74%), and support from healthcare professionals (69%). The rated features were cross-referenced in each app reported being used by participants (n=16 different apps). Most apps allowed nutrient analysis. However, none offered personalization, one app calculated bolus dose, and only one app provided support from healthcare professionals.

Currently used CC mobile apps do not meet the needs of people with T1D. A novel CC app with app-features such as photo recognition, reliable nutrient values and personalized bolus calculations could reduce CC burden.