Live project - Case study
Liberating meal and dose tracking for T1 diabetics
Project: Solo, Personal project
So I’ve had an idea in the back of my mind for a while. For this personal project, I will attempt to update this case study ‘live’, as I work on it in my free time. This first post is a bit of an exploration of what I think I want to research and develop, so excuse the ramble!
Initial brief: Explore ways to increase rate of insulin dosage tracking on Librelink app for type 1 diabetics and different methods for monitoring the impact of meals.
Background
Librelink is an app for monitoring blood glucose levels via a bluetooth connection with a Libre continuous glucose monitor (CGM) device on the user’s arm. Both type 1 and type 2 diabetics can use this to keep their blood sugar in range, with alerts sent to the user’s phone when too high (hyperglycemia) or too low (hypoglycemia or ‘hypo’). For this project I will be focusing on insulin dependent users (type 1s, although some type 2s require insulin).
CGM’s have become an essential tool, improving quality of life and health outcomes of type 1 diabetics. For those injecting insulin throughout the day before, during or after meals (and any other time our bodies release some extra glucose - stress, excitement, nerves..) correct dosing is a huge challenge.
A huge number of factors affect whether you get a rollercoaster ride of highs and lows or a beautiful steady line in range. See below examples just a day apart.
(The following is personal experience, not medical advice, please speak to your healthcare professional)
Getting good control takes time and effort. Carb counting is a common method that particularly in a controlled environment like your home, with familiar foods, good product labeling or a decent scale, can allow diabetics to accurately dose insulin to the measured amount of glucose in the meal.
By noting the effect of one particular meal & dose over the next 4 hours (typical bolus insulin, like Novorapid, peaks within 2 hours, remaining in the bloodstream for 4), you can learn how your body reacts to a particular meal. If no adjustment is required, you’re good to continue that dosing method for similar meals again.
But it gets a little bit tricky when it comes to eating out or - frankly - days when you just can’t be bothered to weigh every gram of carb on your plate. Whether you’re newly diagnosed or a T1 veteran, it can be exhausting. Users are hungry, but need to work out the carbs, remember how their body reacts to a particular combination of fats, proteins and carbs, decide when and how much to dose (assuming they’ve already worked out a reliable carb:insulin ratio). This can lead to a bit of guesstimation, or eyeballing it, which tends to get easier over time, but holds plenty of risks.
Currently, the Librelink app enables users to input the carb content and insulin dose in a note, that is then plotted on the glucose graph. (See images). Regular inputting of this data can help the user, and their doctor, to understand their average doses and any trends that could require adjustment. This is particularly useful for newly diagnosed as they get used to the process. However, within the app, there is no way to easily browse through past notes or quickly search for a similar meal.
What do I want to find out?
I want to see if there’s a way to make this whole process easier. I’d like to start my research looking into diabetics’ current experiences of using this app:
Are they using the dose and carb tracking feature and with what regularity?
How they find the experience of trying new foods and eating out.