1. There’s an app for that! Kelly Grebenc-Rukavina, RD CDE
Diabetes Clinic
AB Children’s Hospital, Calgary AB
April 10, 2012

2. In diabetes, there are apps for just about everything!

3. We will look at: ACH Clinic survey Quick look at the literature
Carb counting/nutrition, GI, Lifestyle & Diabetes management apps
Considerations when choosing apps
Top picks

4. ACH Diabetes Clinic Survey
199 clinic patients/families completed survey before being seen for clinic visit (June 2011)
29% reported using/ have used apps
Numbers & frequency of use:
33 families used Nutrition apps
26 families used Diabetes apps

5. ACH Clinic Survey (cont’d)
Who uses / used them?
47% were moms
26.5% were dads
26.5% were kids (age range: 8-17yrs)
Types of apps used?
19 different apps were identified
-14 for nutrition / carb counting
-5 were for diabetes management
Price range: free - $9.00

6. ACH Clinic Survey (cont’d)
Devices used:
43% - iPhone
28% - iPod
15% - Blackberry
6.5% - Android
4.3% - Internet
2.2% - iPad

7. What does the literature say?
Few articles specific to use of apps alone & improved diabetes outcomes
Success in reduction in A1c when there was a transfer of info to & from HCP’s using mobile devices/ secured web portals/ advice given via text messaging
May change how we manage diabetes

8. Considerations when choosing apps
Must be easy to use
Must be affordable
Meet technology needs
What do you want it to do?
Carb counting only or other nutrition info also
Count / track calories
Track physical activity
Quantify energy expended in physical activity?
Record BG/ insulin doses/ track results
Make recommendations
Interact with HCP or peers

9. Considerations when choosing apps
Nutrition / Carb Counting apps:
Should have multiple food choices
-individual foods, commercial products, restaurant choices
Ability to modify portion sizes
Ability to verify nutrient database
Program in own recipes / Recipe calculations
Some have scan feature

10. Considerations when choosing apps
Lifestyle apps
Track food intake: record calories (& carb)/ compare to goals
Track activity
Set / track weight goals
Help with menu planning/shopping lists
Grocery store scanning feature
Track BP levels

11. Considerations when choosing apps
Diabetes management apps
Record carb intake (some have food choices/ some just enter carb)
Record BG results / display trends
Record insulin doses
Track activity
Easy download for review/ transfer to HCP’s

12. Top Picks Caveats: It’s an ever changing environment!
What’s works for one may not work for
another!

13. Top Picks Carb Counting /Nutrition Fast Food Calorie Counter
Eating away from home:
Fast Food Calorie Counter
Restaurant Nutrition
Individual restaurants:
eg – McDonald’s Nutrition Calculator /Tim’s/ myStarbucks

14. Fast Food Calorie Counter Restaurant Nutrition

15. McDonald’s Nutrition Calculator

17. Top Picks Carb Counting /Nutrition My Food Calorie King
Foods at home:
My Food
Calorie King
Nutrition Menus
Carbs & Cals

18. MyFood

20. Nutrition Menus

21. Carbs and Cals

22. ALowGIDiet

23. GI Food

24. Diabetes Skillet

25. Top Picks Lifestyle apps Lose It Nutrition Menus myFitnessPal
MyNetDiary
Calorie Counter by Fat Secret
Calorie Tracker—Livestrong

27. Top Picks Diabetes management apps LogFrog Track 3 Insulin Calculator
Diabetes Pilot
OnTrack
Vree (T2D)

29. Track3

30. Insulin Calculator

31. Diabetes Pilot

32. Wrap-up There are an endless number of apps to choose from
Determine what info you want the app to provide
At this point - no evidence that simply using an app will improve metabolic control
Apps serve as another tool in the diabetes mgt toolbox

33. Thanks ACH Clinic families who completed survey
ACH Clinic staff who helped collect surveys, provided articles for review and tested apps
Sabrina Poonja—Next Generation Summer student—collated survey & helped with literature searches

35. Up and coming…. BANT–by Telus & Sickkids iPhone/Touch
-Next step RCT study
iPhone/Touch
Wireless download of BG
Focus on self-management
-app asks questions to consider based on trends of data
Social media component

36. bant: a Next Generation Diabetes App for Informed, Activated Individuals and Families

38. What does the literature say?
Diabetes managment:
Diabetes Technol Ther: 2008 Jun: 10(3):160-8
30 pts with T2D from community MD offices
Randomized: intervention group received cellphone software (WellDoc). HCP’s provided real-time feedback to pts via secured web-based servers.
Results: significant reduction in A1c for intervention group

39. More in the literature Weight loss study:
Public Health Nutrition 12(12): Dec 2009
Randomized 125 healthy adults (age25-44yr);
BMI: kg/m2
After 1yr, those who received text messages with advice re reduction of intake, increased acty & feedback were more successful with sustained wt reduction & positive change in waist circumference

40. More…. Meta-analysis studies looking at
use of mobile phones or text messaging
Diabetes Medicine: 28(4):455-63, 2011 April
22 trials; meta-analysis among 1657 participants
Revealed reduction in A1c over a median of 6 months
Sub-group analysis of 11 studies: T2D pts reported >reduction in A1c than studies with T1D pts