Comprehensive Analysis of the Real Lifestyles of T1D Patients for the Purpose of Designing a Personalized Counselor for Prandial Insulin Dosing

Abstract

Post-prandial hyperglycemia is still a challenging issue in intensified insulin therapy. Data of 35 T1D patients during a four-week period were analyzed: RT-CGM (real time continuous glucose monitoring) record, insulin doses, diet (including meal photos), energy expenditure, and other relevant conditions. Patients made significant errors in carbohydrate counting (in 56% of cooked and 44% of noncooked meals), which resulted in inadequate insulin doses. Subsequently, a mobile application was programmed to provide individualized advice on prandial insulin dose. When using the application, a patient chooses only the type of categorized situation (e.g., meals with other relevant data) without carbohydrates counting. The application significantly improved postprandial glycemia as normoglycemia was reached in 95/105 testing sessions. Other important findings of the study include: A high intake of saturated fat (median: 162% of recommended intake); a low intake of fiber and vitamin C (median: 42% and 37%, respectively, of recommended intake); an increase in overweight/obesity status (according to body fat measurement), especially in women (median of body fat: 30%); and low physical activity (in 16/35 patients). The proposed individualized approach without carbohydrate counting may help reach postprandial normoglycemia but it is necessary to pay attention to the lifestyle habits of T1D patients too.

Artificial Intelligence and Women Researchers in the Czech Republic

“…Inputs for the SW are (1) complex information on food content (including glycaemia index and reflecting the previous patient's glycaemia reaction to the similar type of food); (2) the amount of active insulin (information available from the insulin pump); and (3) additional information on physical activity and stress (psychic, illness, etc.). The SW uses information about food to be consumed, logbook data analysis and online connection to the food database [60,61]. Improving fitting the insulin dose to real needs improves diabetes stabilization further, with important individual as well as socio-economic impacts.…”

Assessments of energy, macro and micronutrient intakes in children and adolescents with type 1 diabetes mellitus

“…While the fiber intake in 6-10-year-old children was above recommended amounts, it was below in other age groups. Similarly, Stechova et al, found that fiber intake in participants with type 1 DM was below recommended amounts (median: 42% of recommended intake) [22]. Lamichhane et al, stated that the fiber intake of 908 children and adolescents with type 1 DM was below the amount recommended by the American Diabetes Association (14g/1000kcal/day).…”

Impact of Fat Intake on Blood Glucose Control and Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes

“…Several studies from different countries demonstrated a low adherence in meeting nutrition recommendations among T1D children and adolescents, and particular concern emerged regarding high total fat and saturated fatty acid (SFA) intake [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. Whether people with T1D were closer to guidelines than controls is debated, since contrasting results are described [ 13 , 18 , 21 , 23 ].…”