225-OR: The Impact of Visualizing Macronutrient Content via Food-Log App "Calomeal" on Glycemic Control and QoL in People with Type 2 Diabetes
Authors: TSUNEMI ASAKO , SATO JUNKO , ENOMOTO MARI , IWAGAKI YUKO , SUGIMOTO SAKAE , SOMEYA YUKI , KIYA MAI , MATSUHASHI EIKO , WAKABAYASHI YUKA , FUNAYAMA TAKASHI , UCHIDA TOYOYOSHI , MIYATSUKA TAKESHI , AZUMA KOSUKE , SHIMIZU TOMOAKI , SATOH HIROAKI , KANAZAWA AKIO , WATADA HIROTAKA 
Published: June 2020

Background: The estimation of nutrient content is difficult, but important for self-management of people with type 2 diabetes mellitus (T2DM). In Japan, food-log app has not been penetrated as a treatment tool yet. That could be because Japanese food is diverse and consists of various ingredients. In this study, we investigated the efficacy of app “Calomeal” that enables the patients to search for what they eat among the database of 26300 kinds of foods and to visualize the nutrients using smartphone.
Method: We recruited 20 people with T2DM in Juntendo University. They used this app for 3 months on the regular treatment. The blood and urine exams were performed monthly. At the beginning and the end of the study, the estimation of food was also assessed by the dietitian and the questionnaires about QOL (DTSQ/PAID) were performed.
Results: 2 were dropped out. 18 participants were 52.3±9.2 y.o., male/female 12/8, BMI 25.8±4.7 kg/m2, and HbA1c 8.1±0.4%. At the end of study, significant reduction was observed in HbA1c and BMI (7.92±0.4 to 7.75±0.5%[p=0.0410], 25.69±5.0 to 25.10±4.8 kg/m2 [p=0.0057]). Reduction of HbA1c and BMI were both correlated to the reduction of carbohydrate (r=0.5018 [p=0.0338], r =0.5542 [p=0.0170]). High correlation was also observed between the reduction of carbohydrate and calorie (r=0.8167 [p&lt;0.0001]). QOL scores showed no-statistically significant improvement. Improvement of PAID score was strongly correlated to how close they could adjust calorie intake to their appropriate amount (r=0.5964 [p=0.0090]). Intriguingly, in some patients, this strong association could be due to not the reduction but the increase of food intake, because the baseline calorie intake of those were lower than the proper amount.
Conclusion: Visualizing nutrients via Calomeal improved glycemic control and BMI by reducing over intake. It is of note that in some Japanese people, the adjusting nutrient intake by raising the calorie may contribute to their QOL.

Disclosure
A. Tsunemi: None. J. Sato: Research Support; Self; Sanofi. Speaker’s Bureau; Self; Daiichi Sankyo, Medtronic, Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. M. Enomoto: None. Y. Iwagaki: None. S. Sugimoto: None. Y. Someya: None. M. Kiya: None. E. Matsuhashi: None. Y. Wakabayashi: None. T. Funayama: None. T. Uchida: None. T. Miyatsuka: None. K. Azuma: None. T. Shimizu: None. H. Satoh: None. A. Kanazawa: Speaker’s Bureau; Self; Novartis Pharma K.K., Sanofi, Takeda Pharmaceutical Company Limited. H. Watada: Advisory Panel; Self; Abbott, Ajinomoto, Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Fuji Film, Janssen Pharmaceuticals, Inc., Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi-Aventis, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Research Support; Self; Astellas Pharma Inc., Bayer Yakuhin, Ltd., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K.K., Kissei Pharmaceutical Co., Ltd., Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharma K.K., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Pfizer Japan Inc., Sanofi-Aventis, Sanwa Kagaku Kenkyusho, Shionogi & Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited, Yakult. Speaker’s Bureau; Self; Astellas Pharma Inc., AstraZeneca, Bayer Yakuhin, Ltd., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K.K., Kissei Pharmaceutical Co., Ltd., Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi-Aventis, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited.