Technological support to intensive insulin therapy by a novel smartphone application in young adults with type 1 diabetes: one center's experience

In our Diabetes Centre at Sapienza University of Rome, Italy, we have been exploring the potential benefits of using technology in diabetes care, with a particular focus on T1DM patients receiving flexible intensive insulin therapy (MDI), who do not take advantage of automatic bolus calcu- lators as do those treated with insulin pumps. Therefore, from its launch in 2016, we have been suggesting the mobile app RapidCalc1 to T1DM subjects using MDI, and with knowledge and experience in technology. We have collected data from 16 patients using this app continuatively for at least 24 weeks (Table 1). These users have been reevaluated as per routine clinical practice and interviewed for assessing the adherence to the app’s calculation, specifying how often they used the app as a help for diabetes management (sev- eral times a day / once or twice a day / several times a week / once or twice a week) and for recording self-reported glu- cose variability (detection of blood glucose values above/ below the optimal thresholds identified by the diabetologist and severe hypoglycemic events). Moreover, indicators of well-being and quality of life were evaluated in all the patients, especially fear of hypoglycemia, social interaction, and physical activity. In particular, patients were asked to report whether health status represented a limitation for daily activities and if this limitation resulted in emotional stress, with negative consequences on normal social interac- tion and on feelings and emotions, as assessed by the SF-36 Health Questionnaire.