# MobiDabet: Mobile Telemonitoring System for Patients with Type 2 Diabetes Mellitus (T2 DM)
## 1 Introduction  
Considering data from countries reported by the International Diabetes Federation (IDF) in 2019, 463 million people had diabetes, of which 90% had type 2 diabetes mellitus (T2 DM) [1]. In Mexico, the 2016 National Health and Nutrition Survey (ENSAUNT) reports a prevalence of previously diagnosed diabetes mellitus of 9.4%. On the other hand, and according to the National Institute of Statistics and Geography (INEGI), type 2 diabetes mellitus ranks second as a cause of mortality with 105,574 deaths [2]. Diabetes is a metabolic disorder resulting from insulin secretion deficiency, the inappropriate action of this hormone, or both conditions' coexistence. Long-termchronic hyperglycemia is accompanied by damage, dysfunction, and various organs' insufficiency, especially eyes, kidneys, nerves, heart, and blood vessels [3]. According to the official Mexican standard NOM-015-SSA2-2018 focused on prevention, detection, diagnosis, treatment, and control of diabetes mellitus [4], the treatment that patients with T2 DM must carry out includes the adoption of a comprehensive management plan, which involves the establishment of treatment goals adapted to the characteristics of the patient, non-pharmacological management, pharmacological treatment, patient education, self-monitoring, and early detection/palliation of complications. Furthermore, the medical personnel, who follow up on these types of patients, must have information about glucose levels, calorie intake, and physical activity that patients perform periodically to identify changes in their state of health early and take the appropriate actions [4]. In this context, some works [5; 6; 7; 8; 9; 10; 11; 12; 13] have proposed systems focused on the monitoring, control, and treatment of people with T2 DM. However, these systems lack necessary services that contribute to the personalized management of diabetes, such as:  
* Recommendations by specialists (physicians and nutritionists) mainly in potential risk situations,
* Diet control that includes menus and eating patterns prepared by specialists and assigned according to the calories needed by each patient, and
* An educational approach that guides and sensitizes patients about the possible complications of their condition. Therefore, in this work, the analysis, design, development, and preliminary usability assessment of a telemonitoring system focused on the monitoring, control, and remote nutritional therapy of people with T2 DM is presented. Our system comprises two mobile web applications, one oriented to medical personnel (physicians and nutritionists specializing in this condition) and another focused on the patient. The patient's mobile web application provides the following services: record glucose data; generation of risk alerts (abnormal ranges); choose several food menu options provided by the nutritionist; consult food equivalent to those suggested; receive and/or consult recommendations made by the nutritionist; review results of laboratory studies; consult health education material, and answer the food intake frequency questionnaire. On the other hand, the mobile web application focused on health personnel provides the following services: patient medical history management; consult results of the food intake frequency questionnaire; record patient laboratory results; generate recommendations by the nutritionist; register menus and eating patterns by the nutritionist; management of material for health education (videos); and record the anthropometry of patients. Services developed in our system were reviewed, validated, and evaluated in terms of usability by medical specialists, nutritionists, and patients. Based on the obtained results, our telemonitoring system shows a satisfactory/favorable opinion in terms of usability from the users' perspective.