622-P: Carbohydrate Counting and Bolus Calculator Mobile-Based Application in Adults with Type 1 Diabetes Mellitus—A Randomised Controlled Study

Introduction & Objective: Carbohydrates counting is crucial for proper glycaemic control of Type 1 diabetes mellitus (T1DM). We aimed to study the usefulness and safety of a mobile application (app) for Carbohydrates counting and bolus calculation (CHOC/BC) developed at King Fahad medical city, Riyadh.

Methods: The study included 127 subjects (63 controls) with T1DM using multiple daily insulin injections. Subjects were randomised to either use CHOC/BC app or continue using conventional nutritional management. Patients were taught about Carb counting and using the app in the first visit by a trained nutritionist and remotely followed every two weeks. Insulin sensitivity factor, Carbohydrates ratio and glucose target were calculated for each subject separately. Three months glucose data were recorded using Ambulatory glucose profile.

Results: The mean age of subjects was (mean±SD) 26.7±4.8 (39.1% males) and controls 26.6±6.5 years (54% males). Subjects on CHOC/BC app had better time in range compared to controls 51.2±11.6 vs 46.2±13.0% p=0.02 respectively, that is mainly driven by an improvement of Time above 250 mg/dl 17.3±11.6 vs 24.1±15.7% respectively p=0.002. Average glucose was better in app users 179.2±27.9 vs 191.7±35.8 mg/dl p=0.03. Glucose variability assessed by coefficient of variation was better in app users 39.8±5.5 vs 41.9±5.8 p=0.045. Time below range was not statistically different between the two groups 3.6±3.0 vs 3.8±2.4 % p=0.3. Furthermore, the CHOC/BC users didn’t gain significant weight compared to controls 67.3±15.1 vs 68.6±14.3 kg respectively p=0.6. HbA1c was not different between both groups 7.93±0.8 vs 8.15±1.0% respectively p=0.1.

Conclusions: CHOC/BC application was associated with better control of glucose and lower glucose variability without increased risk of hypoglycaemia or weight gain.