Glucose-sensor-based app improves type 1 diabetes management

Toschi E, Fisher L, Wolpert H et al (2018) Evaluating a glucose-sensor-based tool to help clinicians and adults with type 1 diabetes improve self-management skills. J Diabetes Sci Technol 12: 1143–51 
 

• It can be difficult to identify and address the causes of glucose variability in people with diabetes and the focus for those on basal/bolus insulin is usually on modifying self-care behaviours and food choices.
• An uncontrolled pilot study was carried out to assess whether a self-care management mobile app could assist clinicians and type 1 diabetes patients in identifying and changing self-care behaviours that contribute to glycaemic variability. Four outcomes were measured: HbA_1c, total daily nutrient intake, single glycaemic outcome score (to better understand attitudes that promote or prevent improvements in glycaemic outcomes), and participants’ approach to technology and glycaemic management.
• Thirty people with type 1 diabetes and a baseline HbA_1c of 58.5–75 mmol/mol (7.5–9%) used the Sugar Sleuth app, which incorporates the FreeStyle Libre glucose sensor, for 14 weeks. Sugar Sleuth prompted participants to enter details of food they had consumed, insulin administered, and suspected causes of glycaemic excursions. Participants and clinicians then reviewed the data and devised a self-care plan.
• During the study period, there was a significant reduction in average HbA_1c (5.5±0.8 mmol/mol; 0.5±0.07%) and a reduction in mean daily carbohydrate intake (−43±21 g). There was a significant negative association between single glycaemic outcome score and hypoglycaemia tolerance, and a positive correlation between motivation to change behaviour and HbA_1c reduction.
• Researchers concluded that the Sugar Sleuth app in association with the FreeStyle Libre facilitates changes in self-care skills that improve glycaemic control. They considered the app to be a highly flexible tool that can be used in clinical settings to create personalised action plans for patients and proposed further research based on the results of their pilot study.

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