A Pilot Study of Intervention With a Mobile Application Visualizing the Macronutrient Content for Type 2 Diabetes at a Japanese Center

Asako Tsunemi, Junko Sato, Sakae Sugimoto, Yuko Iwagaki, Mari Enomoto, Yuki Someya, Mai Kiya, Eiko Matsuhashi, Yuka Wakabayashi, Takashi Funayama, Tomoya Mita, Toyoyoshi Uchida, Takeshi Miyatsuka, Kosuke Azuma, Tomoaki Shimizu, Akio Kanazawa, Hiroaki Satoh, Hirotaka Watada


Background: Estimating the nutritional content of food is essential for self-management in people with type 2 diabetes mellitus, but it is a difficult skill to learn. The aim of this study was to investigate how diabetes management was impacted by the ability of patients to search for items they ate from a database of 26,300 different foods, and to visualize nutritional intake using the Japanese mobile application (app) "Calomeal."

Methods: This was a single-arm, single-center, pilot study. Eighteen outpatients with type 2 diabetes mellitus used the "Calomeal" app for 3 months. The primary endpoint was change in hemoglobin A1c (HbA1c). Secondary endpoints were changes in body weight (BW), lipid parameters, and quality of life scores.

Results: The baseline characteristics of the study subjects were as follows: age: 53.4 7.8 years; male/female ratio: 11/7; HbA1c: 7.9 (7.58 - 8.23)%; and body mass index (BMI): 25.17 (21.63 - 28.59) kg/m2. Significant reductions in HbA1c and BMI were observed over 3 months (HbA1c: 7.9 (7.58 - 8.23)% to 7.6 (7.3 - 8.23)%, P = 0.0410; BMI: 25.17 (21.63 - 28.59) to 24.54 (21.57 - 27.81) kg/m2, P = 0.0057). Reductions in HbA1c and BMI both correlated with decreased carbohydrate intake estimated by the mobile app.

Conclusions: Japanese patients who used their smartphones to visualize their nutritional intake using the "Calomeal" app demonstrated improved short-term glycemic control and BMI. Although the validity of the results should be tested in future randomized controlled trials, this approach may be a clinical option for improving self-management in Japanese patients with type 2 diabetes mellitus.

J Clin Med Res. 2021;13(8):425-433
doi: https://doi.org/10.14740/jocmr4558


Medical nutrition therapy; Mobile applications; Self-management; Type 2 diabetes mellitus

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