Diabetes Interactive Diary: A Mobile Phone-Based Telemedicine System for Carbohydrate Counting and Bolus Calculator

A flexible therapy for type 1 diabetes based on carbohydrate counting and insulin dose adjustment can promote glycemic control and quality of life without worsening severe hypoglycemia or cardiovascular risk. The complexity of the standard education required by the flexible therapy can be managed with the ‘Diabetes Interactive Diary (DID)', a carbohydrate/bolus calculator for mobile phones. It also works as a telemedicine system based on communication between patient and physician via text messages (SMS). The efficacy and safety of the DID have been tested in 3 main studies. The DID was demonstrated to be effective in improving metabolic control as well as standard education while ensuring several additional benefits. First, it halved the time dedicated to education and simplified the calculation of carbohydrates content and insulin doses, allowing more individuals with type 1 diabetes to adopt the flexible regimen. Second, the use of the DID was also associated with an 86% decrease in risk of grade 2 hypoglycemia. Additionally, several quality of life scales were significantly improved, suggesting that the use of telemedicine can increase the acceptance of insulin treatment and help patients cope with the disease. Currently, the DID is available as a free app for smartphones.