How m-Health application on nutrition informatics can be useful for diabetic care at home?

m-health application for health care is an amazing idea but I believe more work is needed to increase its reach among the rural population. //www.tandfonline.com/doi/full/10.1080/13648470.2016.1263824 this study shows data of 2015 from rural areas of Andhra Pradesh and their lack of accessibility to mobile phones. The scenario for sure might have changed now, but yet we can't deny this issue.

Components mentioned by @bhavya would be wonderful features to the app. Along with those I would suggest the app should have offline functionality and should be compatible with older android versions too so that it is easily accessible to people with most basic smartphones too. voice operations and interaction (similar to google assistant) could be a very helpful feature for the old and other population who may have difficulty in operating phones and apps.

In order to live a healthy and complication free life self-management of diabetes is essential. In my view, apart from features like storing and tracking blood glucose levels the m-health app may contain a food journal and a list of foods with low glycemic load so that user may select from those particular foods for their meal preparation as low glycemic foods are digested slowly thereby increasing blood sugar levels steadily.

Since Diabetes is a lifelong disease, Education becomes the most important aspect in its management. m-health app can also contain a feature where the myths and common food fads regarding diabetes are clarified and they could connect with health professionals to clear their doubts. It can incorporate features like monthly reminders to check their lipid levels, and reminders like meal time, time to walk and time for meditation. The app can have key points in a highlighted form for prevention of its complications.

In my opinion, m health app development is an amazing idea to acknowledge, intervene and make diabetic patients life easier.
I would like to suggest if this app has SICK day guidelines so the person might get a hands-on information to what to do when he is alone and hypoglycemic.

Agreeing to what @surbhi says, help groups are a great way to communicate among other diabetics around.

Also I feel there should be a column for the do's and don'ts in diabetes management where we could talk about the carb counting, food exchange list, portion sizes, exercise routines, insulin regimens which would help the user to take appropriate action and help in better decision making.

I would also recommend here some opening quotes when the app begins to run to motivate and inspire the user and make them feel more connected.

I feel the app should have a basic questionnaire like any disease that runs in the family like as diabetes or cancer; the user's height, weight and dietary recall or may be a food frequency questionnaire to collect the dietary information to personalise feed on their dashboard.

I agree with @sadaf on having notifications for exercise, insulin or medications and also @suroor on the idea that the app should link health professionals along with the users so they are counselled based on their tailored needs.

Self monitoring in diabetics is an essential way to improve quality of life as well as reduce complications. Mobile application for diabetic care would be an infallible way to ensure diabetics receive constant, support and monitoring provided people are aware and ensure long term use of these applications.

While most adults can be made to understand diabetes, children and adolescents effected with diabetes may fail to entirely understand the implications diabetes has in daily life. Therefore I think that they may benefit from an application which combines nutrition informatics and gamification features to encourage the child to make healthier food and activity choices.

If the app includes regular features such as easy carbohydrate counting, insulin reminders, physical activity, blood glucose monitoring etc coupled with daily goals and reward features in the form of points, level ups when insulin regimens are maintained, it may help encourage the child. Additionally an interface which connects the parent/ care givers, the child and the doctor on one platform would help contribute in collaborative management of diabetes for the child. 

Self management is the most effective method for controlling blood sugar levels for diabetics. An
app should have the following features :

1. The main feature of the app should be that it should be interactive so that the users can
clear their queries instantly.
2. The app should maintain a record of glucose and lipid levels and monitor them .
3. Importance of inculcating foods like Fenugreek and Nigella seeds which have proven
beneficial effects should be included in the diet.
4. Carbohydrate counting should also be an important aspect of the app.
5. Screening in diabetics is essential to prevent complications ,the app should provide
reminders regularly.
6. Exercise and recipes should be updated daily.

Thus M- health applications can prove as a successful method for monitoring blood glucose levels
diabetics at home.

Diabetes Being a chronic illness & a lifestyle disease that mainly disturbs the usage of energy in a person's body and with global prevalence rised upto 9.3% (463 million people), that could be rising to 10.2% (578 million people) by 2030 & 10.9% (700 million people) by 2045 due to the irrational eating habits & pattern of people, it's necessary for healthcare systems to adapt some greater measures to reduce the prevalence of diabetes & to improve their condition.

m-Health application for Nutrition Informatics for Diabetes care at home is an excellent way to engage with diabetic patients all across the globe easily, just a click away. The application could include patient recording his/her food intake by the patient for the whole day, patients daily blood glucose level readings, the amount of insulin injected for type-1-diabetes, patient's medicine prescription. Then the app doctor can personally examine the eating pattern & other factors of several patients & come up with better medical nutrition therapy for them. This could be useful for improving patient's condition. 

The m-Health application should also include a section where a easy graphical explanation of Diabetes, it's types, pathophysiology, causes, symptoms, diagnosis, prevention, treatment with easy terms just to keep the patient educated about their condition. 

With so many medical & nutritional terms the app should also have a section of small dictionary for terms used that could be misunderstood by patients such as simple carbs & complex carbs this could only be understood by Nutrition informants.

The app should include the blood glucose level readings (less, normal, or high), Including a voiceover or personal chat with the virtual Doctor & Dietician would be really helpful for the patient's to follow the given diet pattern as the Dietician can examine the day-to-day food intake with the help of food record filled by patient. Daily Diabetes-friendly recipes could also be shared by the informants for the patient's.

Through m-Health application prevention of Diabetes should also be explained to the patient's so that is helps their family members or their  children to improve & prevent Diabetes in future. It should also be free instead of being a paid app so that more and more patients download & join the App.

For conclusion by developing a m-Health application of Nutrition Informatics for diabetes care from home it could improve the patient's condition, reduces the risk of condition, the prevalence could decrease in urban area as it's more prevalent in urban areas

Mobile technology has revolutionized virtually every aspect of modern life, including the ways in which we manage our physical and mental health, search for and find health information, and even access healthcare. From online patient portals to mobile applications, technology has truly transformed modern health care allowing for huge improvements in quality of patient care, reduced care healthcare costs, and making healthcare more accessible to a larger number of people. A m-health app for diabetics should contain the following modules:

A module containing list of low glycemic, moderate glycemic and high glycemic foods so that person can plan his meals wisely.

A module should contain tracking physical activity because it is important for a diabeteic patient to be physical active which helps control blood glucose level.

Tracking of meals that is carbohydrate counting should be one of the module as it is important for diabeteic to know the amount of carbohydrates ingested.

A module for storing the past medical records should also be there to track his performance that is whether he is able to maintain blood glucose levels or not.      

Mobile health technology has been highly beneficial for people with chronic conditions, and is especially useful for people who have diabetes.Between tracking blood sugar, meals, exercise, and medications, people with diabetes must record and manage an abundance of important information related to the condition of the patient.

The app should contain different recipes which can be used by the patients of diabetes. And also it should be able to track the physical activity of the person which is important for the diabetes patient and it should also include carbohydrate Count and gylcemic index values.The app should also contains how to use SMBG(self Monitoring Blood Glucose ) so that he can monitor his blood glucose 

The following paper focusses on lack of information among diabetic patients regarding which m-health apps are effective in improving their health outcomes. It assesses the evidence, usability and features of these apps for self-management of type 1 and type 2 diabetes. The researchers of the study extracted the technical specifications and costs and evaluated the usability of 13 apps. Common features of apps included the ability to track blood glucose, HbA1c, medications, physical activity, and weight. For type 1 diabetes, patients had clinically significant improvement in HbA1c if they used either of two apps and statistically significant improvement using one additional app. For type 2 diabetes, patients using any of the three apps experienced a clinical and statistical improvement in HbA1c. Patients using two apps for type 1 diabetes experienced improvements in hypoglycemic episodes. Patients did not experience improvements in quality of life, blood pressure, weight, or body mass index outcomes, regardless of the app or type of diabetes. Study design and presentation made it difficult to distinguish the effect of the app and the effect of additional interactions with study personnel or health care providers. The study concluded that while few apps for diabetes self-management may improve outcomes in the short-term, the effects cannot be distinguished from the concomitant effect of additional support from a doctor. Hence, more rigorous and longer-term evaluations are needed to determine how these apps affect weight, blood pressure, quality of life, and complications of diabetes. 

Read more: //effectivehealthcare.ahrq.gov/sites/default/files/pdf/technical-brief-31_mobile-health-applications-for-self-management-of-diabetes.pdf

Diabetes  is the leading cause for most of the chronic diseases. People with diabetes are at higher risk of developing complications in many parts of the body . It is important for a person to maintain their blood glucose levels and their overall health . Along with the track on the blood glucose levels it is necessary to keep track on their blood pressure as well . The basic features in the app should be the correct measuring for blood glucose levels as most of the apps doesn't give proper results . It should also have the facility to check the blood pressure . It should not be limited to any particular group  and should be affordable for everyone regardless of the economic background , there should be no such rule to get premiums . It can be made more interesting by including  the facts,  myths and foods to be included and avoided, which would help people have better understanding about diabetes and the  important thing is language shouldn't be the barrier  , the app can be made available in basic languages  .

The management of the diabetes consists of lifestyle modifications which include weight management, regular exercise and Dietary modifications and, if unsuccessful, the pharmacological intervention. For many Diabetics, the diagnosis and management of the condition challenges their lifestyle habits including exercise and diet. Therefore, many Diabetics still show low willingness to change their unhealthy lifestyle habits. So to overcome these barriers, technology can play an important role in supporting patients’ behavioral changes by providing an empowering, portable every-day reminder of their diabetes management plan.

Health care by mobile applications (apps) will have a great advantage when applied to patients with diabetes in a way that it will improve their adherence to self-management activities like taking regular medications and insulin injections, self-monitoring of blood glucose (SMBG), diet, and exercise.

In conclusion, I believe that user-tailored interventions may be a good strategy for successful mobile-based diabetes care. The m-Health application should provide a real-time report on their nutritional intake and tailored advice based on the user's dietary recordings, Body mass index, blood glucose levels, previous medical history, and medications. These approaches may make the mobile diabetes intervention more effective and powerful.

Read more :

Rinaldi, Giulia et al. “Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: a protocol for a systematic review.” BMJ open vol. 9,4 e027490. 11 Apr. 2019, doi:10.1136/bmjopen-2018-027490

Jo, In-Young et al. “Diabetes Management via a Mobile Application: a Case Report.” Clinical nutrition research vol. 6,1 (2017): 61-67. doi:10.7762/cnr.2017.6.1.61

As mentioned above diabetes is a global concern which must be taken care of. In my opinion technology is a smart way to connect people all around the world and the use of technology in case of healthcare systems has been tremendously increasing everyday. In this day and age smart phones are being used by everyone irrespective of their socioeconomic status and are helpful in giving health related information through various apps. There are many apps which are developed for diabetes management, every app is being designed in such a way that it gives information about what kind of food, medications should be consumed, exercises to be done or give information about the GI value of foods and how to monitor blood glucose levels and other life style changes to be done etc., but we must also focus on how much the user is able to understand and whether the user is getting the information correctly or not. I personally feel like there is a need to include language translation option in order  to provide information  in their native language which can be easily understood by the user and can get the correct information without getting confused.  

India is the diabetic capital of the world. This unprecedented rise in the diabetic burden, demands innovative solutions in health care. Diabetes education and self management via the assistance of an health app can help develop better management of the chronic disease.

The current available applications in the diabetes space seem to fill for the most part instructive or enlightening needs and blood glucose and insulin following for patients with Type 1 diabetes. The blood glucose trackers appear to be generally welcomed and many are popular in the application store. Though these instruments are play a significant role in connecting the paper-electronic hole, there is an incredible requirement for top notch devices that can be recommended by doctors and whose utilization can be observed by a medical services group. The devices need to catch extra information that can be utilized to deal with the entire patient and their sickness, not simply a little piece of the patient's consideration. Self management and care is an extremely important aspect in diabetes, and for this we need to give them more modern apparatuses inside the setting of the patient-doctor relationship that guarantees that patients have the direction that they need for their condition. The applications need to likewise give medical services groups the instruments they need to circle back to patients, guarantee lab tests are done, therapy is working and that patients are sticking to the right diet, lifestyle and medicine.

Currently there are various diabetic apps providing various functions but not all the functions and not standardized apt results. Any application that enters the market for use a for any disease management should be able to provide some baseline functions. There is a requirement for standard mhealth application accreditation that could be created and controlled by a valid and credible organization .  Certifications of apps can give an essential degree of trust to the doctors and patients and also ensure effective management of diabetes or any disease or disorder.

Read more: //www.researchgate.net/publication/314089823_Diabetes_mHealth_Apps_Can_they_be_effective

To prevent from complications of diabetes self monitoring is important. Although mobile app is not a complete solution to the problem but it helps the person for greater extent.  The app should maintain a  record of blood glucose levels, it should have complete information regarding complications also. Carb counting should be included. Awareness on glycemic index and foods which are having low and high glycemic foods should be mentioned. Health care professional should be available in case if the client wants to contact and get the personalised diet. Importance of maintaining meal timing is also important so some kind of reminders help them. Reminders for regular checkup. Inclusion of functional foods and their importance in adding them in their regular diet. It should also have a physical activity reminder. Some simple and easy receipes should be included in the app. App should also collect some general information like height, weight and it should also calculate BMI. Assesment questionnaires should be included to know the condition of the client, apart from diabetes. It should be free app instead of paid. It would be better if some videos and sessions are updated on the app by professionals regularly.

Diabetes is increasing and already it gave us an alarm that it need to be controlled.

Self-monitoring of blood-glucose levels has always shown positive results on the condition of the patient. Irrespective of rural and urban population, the usage of smart phones is quietly high in the population. So, awareness of m-health apps should be popularized greatly among the people so as to maintain their health.

Diabetes can be monitored and even to some extent can be controlled by the usage of m-health apps with specific features in the application:-

1) The app should give a notification for taking insulin doses.

2) Diet and exercise timings should be notified.

3) Healthy diabetic recipes should be available in the app.

4) Positive news related to decrease in diabetic number should be available.

These should be few key features of the m-health app and the m-app should be completely tailor-made.

As a health-professional cannot be available 24/7 with the patient, these type of m-health apps can be handy to diabetic patients.