Researchers in Peru adapted a Swiss smartphone app called WebDia to help young people with type 1 diabetes manage their condition better. The app teaches patients how to count carbohydrates in food so they can take the right amount of insulin. A team customized the app to include Peruvian foods, then trained healthcare workers, children with diabetes, and their families how to use it. After three months, both the healthcare workers and families reported the app was easy to use and helped them understand diabetes management better. This shows that adapting health technology to fit local foods and cultures can help more people around the world manage their diabetes.

The Quick Take

  • What they studied: Whether a smartphone app designed to help people with type 1 diabetes count carbohydrates in food works well when adapted for Peru’s different foods and culture.
  • Who participated: The study included 25 healthcare workers, 25 children and teenagers with type 1 diabetes, and 31 family members or caregivers from three different regions in Peru.
  • Key finding: Healthcare workers improved their knowledge about diabetes by 3.5 points on a test scale after training. Both the healthcare workers and families found the app easy to use and said it helped them better understand how to count carbohydrates in Peruvian meals.
  • What it means for you: If you or someone you care for has type 1 diabetes, apps customized for your local foods may make managing blood sugar easier. However, this was a small pilot study, so larger studies are needed to confirm these benefits work over longer periods.

The Research Details

Researchers took an existing app from Switzerland called WebDia and customized it for Peru. First, a dietitian created a database of Peruvian foods and how many carbohydrates each contains. This list was checked by diabetes experts from Switzerland and Peru to make sure it was accurate. The customized app, called WebDia-Mundi, was then tested with a small group of children with diabetes and their families to see if it worked well.

Next, the research team held three-day training workshops in three different Peruvian cities. The first two days trained healthcare workers about type 1 diabetes and how to teach carbohydrate counting. The third day brought together healthcare workers, children with diabetes, and their families to learn how to use the app together.

The researchers measured success by checking knowledge tests, asking people about the app’s ease of use, and measuring blood sugar control (using a test called HbA1c) at the end of training and again three months later.

Type 1 diabetes requires careful management of insulin doses based on carbohydrate intake, but many people in low- and middle-income countries don’t have access to proper training. By adapting existing technology to local foods and cultures, researchers can help more people worldwide manage their diabetes effectively. This approach also shows how successful health tools can be shared and customized rather than starting from scratch in each country.

This was a pilot study, meaning it was small and designed to test whether the approach works before doing a larger study. The sample size was modest (81 total participants), which limits how much we can generalize the findings. However, the study used a mixed-methods approach (combining numbers and personal feedback), included multiple perspectives (healthcare workers, patients, and families), and had expert review from both Swiss and Peruvian specialists, which strengthens the reliability of the results.

What the Results Show

Healthcare workers who received training showed significant improvement in their knowledge about type 1 diabetes, with an average increase of 3.5 points on their knowledge assessment. This suggests the training program was effective at teaching healthcare workers the skills they needed.

Both children and teenagers with diabetes and their caregivers reported that WebDia-Mundi was easy to use and helpful for understanding how to count carbohydrates in their meals. They felt more confident about managing the disease after using the app. The fact that people found the app user-friendly is important because apps that are difficult to use often get abandoned.

Healthcare workers also gave positive feedback about the workshop overall, indicating they felt the training was valuable and well-organized. The customization of the app to include Peruvian foods appeared to be important—people appreciated seeing familiar foods in the database rather than generic international options.

While the study measured blood sugar control (HbA1c levels) at the beginning and three months later, the abstract doesn’t provide detailed results on whether blood sugar improved significantly. This is an important outcome that would need to be examined in the full research paper. The study also measured quality of life, though specific results aren’t detailed in the summary provided. These measures are important for understanding whether the app actually improves health outcomes, not just whether people like using it.

This research builds on existing work showing that carbohydrate counting is important for managing type 1 diabetes. The innovation here is adapting an existing successful app (WebDia from Switzerland) to new countries rather than creating new apps from scratch. This approach of customizing proven tools for different regions is becoming more common in global health technology. The study demonstrates that this adaptation strategy can work, though more research is needed to compare how well adapted apps work compared to the original versions or other approaches.

The study was small, with only 25 children and teenagers participating, which limits how much we can apply these findings to larger populations. The study only lasted three months after training, so we don’t know if people continued using the app or if benefits lasted longer. There was no comparison group (like people who didn’t use the app), so we can’t be completely sure the app caused the improvements rather than the training itself. The study was conducted in Peru, so results may not apply to other countries with different foods, healthcare systems, or technology access. Finally, the study didn’t include detailed information about whether blood sugar control actually improved, which is the most important health outcome.

The Bottom Line

For people with type 1 diabetes in countries where the app is available: WebDia-Mundi appears to be a helpful tool for learning carbohydrate counting, especially when combined with proper training. The evidence suggests it’s user-friendly and improves understanding of diabetes management (moderate confidence). For healthcare workers: Training programs that teach both diabetes knowledge and app skills appear effective (moderate confidence). For researchers and health organizations: Adapting proven health apps to local contexts is a promising approach to improving diabetes care in low- and middle-income countries (moderate confidence). However, larger and longer studies are needed to confirm these benefits.

This research is most relevant for: children and teenagers with type 1 diabetes and their families, especially in countries where carbohydrate counting training is limited; healthcare workers in low- and middle-income countries who want better tools to teach diabetes management; and health organizations looking to improve diabetes care in their regions. This may be less relevant for people with type 2 diabetes (a different condition) or those with access to extensive diabetes education programs already.

Based on this study, people showed improved knowledge and comfort with the app within the three-day training period. However, the study only followed people for three months, so we don’t know how long benefits last. Realistic expectations would be: immediate improvement in understanding carbohydrate counting (days to weeks), potential improvement in blood sugar control within weeks to months of consistent use, and sustained benefits if people continue using the app and applying what they learned. Individual results will vary.

Want to Apply This Research?

  • Track daily carbohydrate counting accuracy by logging meals in the app and comparing estimated carbs to actual carbs (when possible). Measure this weekly to see if accuracy improves over time. Also track blood sugar readings before and two hours after meals to see if better carb counting leads to better blood sugar control.
  • Start by using the app to log one meal per day, focusing on meals with the most carbohydrates. As comfort increases, expand to logging all meals. Set a weekly goal to identify and correctly count carbs in three new Peruvian foods not previously logged. Share results with a healthcare provider or family member weekly for feedback and encouragement.
  • Establish a monthly review routine where users look back at their carbohydrate counting accuracy and blood sugar patterns. Use the app’s tracking features to identify which meals are most challenging to count. Schedule quarterly check-ins with a healthcare provider to review progress and adjust insulin dosing if needed based on improved carbohydrate counting accuracy.

This research describes a pilot study of a smartphone app designed to help manage type 1 diabetes. While the results are promising, this was a small study conducted over three months. The app should not replace professional medical advice or diabetes care from a healthcare provider. Anyone with type 1 diabetes should work with their doctor or diabetes educator before making changes to their insulin regimen or diabetes management plan. The app is intended as a tool to support, not replace, professional diabetes education and medical supervision. Results may vary based on individual circumstances, and the app’s effectiveness depends on consistent use and proper training.