# MobiDabet: Mobile Telemonitoring System for Patients with Type 2 Diabetes Mellitus (T2 DM)
## 6 Conclusions and Future Work  
In this work, a telemonitoring system focused on the monitoring, control, and remote nutritional therapy of people with T2 DM was presented. The system consists of two mobile web applications; one oriented to the medical staff and another to the patient. Our system is characterized by other proposals for offering medical staff and patients services such as 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, answer the food intake frequency questionnaire, and interaction between patient and nutritionist in real-time. Through these services, our system helps to achieve continuous monitoring and control, education, and empowerment of the patient regarding their condition, simplification of medical records, and facilitate decision-making for the improvement of the treatment based on the features of each patient. The offered services in both applications were developed based on the Mexican health standard guidelines focused on the prevention, detection, diagnosis, treatment, and control of diabetes mellitus. These services were reviewed and validated by the Mexican Social Security Institute (IMSS) medical personnel, who also contributed to the analysis and definition of requirements. In this work, our system's preliminary usability assessment was carried out based on a field study with four specialist physicians, two nutritionists, and seven patients with T2 DM. Based on the results obtained regarding efficacy, efficiency, satisfaction, content, navigation, and presentation, our telemonitoring system shows a satisfactory/favorable opinion in terms of usability from the users' perspective. On the other hand, we consider that the main limitations of our system are: a) Users require an internet connection to use the services provided by the system, and b) the system does not allow the general physician to perform interventions on the pharmacological treatment of the patients in real-time. Therefore, our system lacks services that help the physician personalize the patient's pharmacological therapy in real-time. As future work, the following extensions to the system are proposed: \begin{table}
\begin{tabular}{c c c c c c c c} \hline \hline
**Related Works** & **FS** & **US** & **HM** & **EM** & **IM** & **UE** & **EE** & **IAE** \\ \hline Social Diabetes [20] & ✓ & & & & ✓ & ✓ & & \\ USKAYSMS [21] & ✓ & ✓ & & ✓ & ✓ & ✓ & & ✓ \\ S.M.R.P.D. [22] & ✓ & & ✓ & ✓ & ✓ & ✓ & ✓ & \\ \hline \hline \end{tabular} Where FS: Usability assessment based on field study, US: Use of the ISO/IEC 25,000 usability standard, HM: Heuristic methods, EM: Empirical methods, IM: Inquiry methods, UE: User evaluated, EE: Evaluated by experts, IAE: Improvements after evaluation.  
\end{table} 
Table 13: Related works in terms of usability assessment. * To implement our system in a public or private health institution, we consider performing usability tests with patients and physicians during a year. * Automatic calculation of proteins, carbohydrates, and fats that the patient consumes. This for the nutrition module as a complement to the intake frequency answer. * A specialized module for physical activity orientation that allows the patient to perform some exercises in support of the treatment. * Develop a system version integrated with native applications for Android and iOS mobile devices. * Implement a sensor network to obtain medical data of the patients. Conceptualization, A.A.J., E.L.D., and Y.H.V. ; methodology, A.A.J. and Y.H.V. ; software, A.A.J. and M.A.H.V. ; validation, M.A.H.V., M.A.M.N., J.D.L.C., and E.L.D. ; formal analysis, Y.H.V., M.A.M.N., and J.D.L.C. ; investigation, M.A.H.V., Y.H.V., and E.L.D. ; resources, L.O.D. and O.H.S. ; data curation, S.D.I., J.D.L.C., and M.A.M.N. ; writing--original draft preparation, A.A.J. and M.A.H.V.