An eHealth platform for monitoring ketogenic diet therapies in patients with refractory epilepsy (Preprint)

Abstract

<sec> <title>UNSTRUCTURED</title> <p>Ketogenic diet therapies (KDTs) are high-fat, low-carbohydrate, and moderate-protein interventions that have been used over the years to control seizures in patients with treatment-refractory epilepsy and certain inborn errors of metabolism. The mechanism of action of KDTs is thought to be related to molecular changes that are the result of increased systemic ketone-body concentration and decreased glucose levels leading to a reduction in seizure frequency. Therefore, systemic ketone bodies and glucose levels are measured daily in these patients. “My Keto Life” was developed as a dynamic and easy to use web- and App-based monitoring and support tool for epilepsy patients on KDTs. Using this eHealth tool patients are able to regularly record self-measured values, such as ketone bodies, glucose levels, and seizures, to monitor adherence and allow real-time intervention by physicians and nutritionists. Based on non-structured interviews with experts in metabolism, epileptologists, and nutritionists from the KDT team at Hospital Garrahan, Buenos Aires, Argentina, a suitable digital platform was designed and developed to improve care of epilepsy patients on KDTs. Daily self-tracking of ketone bodies and glucose levels, the dynamic recording of food intake, supplements, and antiseizure medications by users, real-time monitoring by and communication with physicians and nutritionists, and personalized reminders for taking anti seizure medications, supplements, and ketone measures are the most prominent features of this tool. “My Keto Life” is a rapid and iterative eHealth tool developed together with physicians and nutritionists for the adequate management of epilepsy patients on KDTs in order to promote patient engagement, facilitate monitoring by physicians, and optimize treatment leading to better therapeutic outcomes.</p> </sec>