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Open AccessArticle

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

1
Department of Internal Medicine, University Hospital Motol, V Uvalu 84, 15006 Prague 5—Motol, Czech Republic
2
The Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, Jugoslavskych partyzanu 1580/3, 160 00 Prague, Czech Republic
3
Fitsport Complex Inc., Polní 1006/11, 664 91 Ivancice, Czech Republic
4
Faculty of Biomedical Engineering, Czech Technical University in Prague, nam. Sitna 3105, 272 01 Kladno, Czech Republic
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(5), 1148; https://doi.org/10.3390/nu11051148
Received: 26 April 2019 / Revised: 17 May 2019 / Accepted: 21 May 2019 / Published: 23 May 2019
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. View Full-Text
Keywords: carbohydrate counting; diet; mobile application; obesity; overweight; postprandial glycaemia; prandial insulin bolus; type 1 diabetes carbohydrate counting; diet; mobile application; obesity; overweight; postprandial glycaemia; prandial insulin bolus; type 1 diabetes
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Stechova, K.; Hlubik, J.; Pithova, P.; Cikl, P.; Lhotska, L. Comprehensive Analysis of the Real Lifestyles of T1D Patients for the Purpose of Designing a Personalized Counselor for Prandial Insulin Dosing. Nutrients 2019, 11, 1148.

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