Development and Evaluation of a Mobile Application for Mealtime Bolus Insulin Dosage Calculation (CarbInHand)

Abstract

Background: The calculation of bolus insulin injection is essential for controlling the blood glucose level in patients with Type 1 Diabetes Mellitus (T1DM). Many studies showed that small numbers of patients could calculate correctly. Therefore, the use of calculation tools may help provide more accurate results.Objective: To develop and evaluate a mobile application for mealtime bolus insulin dosage calculation for T1DM patients.Method: A survey was conducted among the caregivers of T1DM patients to identify the needed interface and functions of the application (app.). Information used in the app was in Thai and was verified by the healthcare expert panel (clinicians, pharmacists, and nutritionists). Twenty participants tested the app. The data on time used in insulin calculation and errors were collected. The participants’ satisfaction was evaluated after seven days of use.Results: The developed app. called “CarbInHand”, could calculate the amount of carbohydrate in foods which determine an adequate dosage of bolus insulin. The accuracy between insulin dosage calculation manually vs using the app were 28.5% vs 42%, respectively. The average time used in calculation manually vs using the app. were 0.755 vs 1.075 minutes, respectively. Participants satisfied with the app. in the highest levels of all aspects assessed. The highest scores were in the installation process and the usefulness to T1DM patients and caregivers.Conclusions: “CarbInHand” is the app. that T1DM patients can use as a tool to assist in the calculation of bolus insulin dosage and carbohydrate counting with high accuracy and satisfaction. The app. contains data on the amount of carbohydrates in 387 food items, reducing the burden of remembering carbohydrates in foods. It can be used offline on iOS and Android operating systems.