Abstract
Background and Aims: Insulin bolus adjustment depends from accurate food carb counting and using optimal insulin‐carb ratios (ICR). Many people with type 1 diabetes (T1D) do not know how to readjust their ICR and need to wait for a medical visit, while benefits expected from using a bolus calculator are not met. Helping them to keep continuously adjusted ICR would be valuable for reaching an optimal glucose control.Methods: During GLUCAL3 study, patients used the mobile application EKIYOU during two months to enter their daily meals, blood glucose values and bolus doses. For each patient, the ICR was revised twice. We evaluated the performance of an algorithm that intends to converge to the optimal patient's ICR in free life conditions while users of the application could forget some inputs or make errors on meal reports.Results: The algorithm was evaluated in 14 T1D patients. The algorithm was initiated with patient's usual ICR or using the “500 rule” and succeeded in less than 10 days to converge to the ICR defined by the patient's physician at the end of the first month. In cases where the algorithm converged to a different value, our sub‐analysis disclosed that the patient had been affected by an intercurrent disease.Conclusions: Our data indicates that our algorithm allows efficient timely updating of ICR in patients with T1D between medical visits.