Why is the app called MoDD? The advice about having a sickness plan seems pointless. Often when one is sick one is least concerned with proper nutrition. One is too busy trying not to throw up what one just ate and one is usually on a BRAT -- aka diabetic unfriendly -- diet.
MoDD stands for Mobile Diabetes Detective. The mobile part comes into play when you create your own account, as much of the interaction happens through SMS to users phones. Feel free to try that.
And good point about the sickness plan advice! I am going to take all the comments back to our research team, so keep them coming!
I tried it out both as test1234 and then set up my own account. I put in 9 fictitious blood sugar readings and tomorrow will only put in 3, maybe 5 the day after and see what pops up. I am sure it will be something about the need to check more frequently and consistently etc.
I have all the alarms and alerts turned off for my Omnipod pump PDM mostly because I am extremely beep weary. I hope my cell phone isn't going to start yelling at me to test my blood sugars.
I never say I am "TESTING" my blood sugar because that implies that it is something that I can fail. I prefer to check my blood sugars.
Great! Creating your own account is probably the best way, as you don't get as much of it with just the test account. Generally speaking, MoDD sends one reminder per day and even that one is optional. You can choose to set more alerts (for example to check your blood glucose at different times of day) but it sounds like that's exactly what you don't like :-)
If you wish to turn ALL reminders OFF, click on your name on the front page, go to Edit Profile & Password, and uncheck the Usage Reminders check-box.
The main part of the app is going from numbers to setting goals, which you should be able to do after you have three days worth of numbers; the frequency is less important. Just click on the numbers in the Average row in the table and follow the steps. Would love to hear what you think about that part.
And ah, good catch! Checking rather than testing indeed, we didn't think of that! Thanks!
I have completed a few days of entries and have entered a bunch of spurious numbers to see what the response would be. I also turned OFF all the reminders - thanks for that. I will start with the things I like about the app. I like the 3 day graph. It is a bit like a Dexcom 3 day trend chart. It is easy to read and interpret. I put in some low numbers for after breakfast readings to test out how it works setting goals. I don't like that the "target range" cannot be modified. While some people are perfectly happy to be 70-179 after meals I prefer to set my own targets. When I chose to set goals for the after breakfast readings I was disappointed by the choices offered : 1. I increased or dicreased (and yes that is how it is spelled) my insulin. It said don't increase or dicrease without discussing it with your healthcare team. If I had to discuss this every time I made a change I would never get off the phone. I ended up putting in a suggestion of my own just because none of those presented applied to my situation but I doubt it will make it into general use because this seems to be a more "generalized" app. But I would suggest running a spell check before actually launching it.
Thank you for the comments! Interesting point about target changing target ranges, we will need to think about that. How do you determine what you would like your target ranges to be? Are they usually stable, or do you change them from time to time?
In terms of the "dicreased" - ah, what a catch! We had two professional copy-editors go through all our content (one of them was also a health communications expert), but I guess this one slipped through the cracks somehow. I already corrected that.
As for your recommendation - thank you! This is what we are hoping for. I am going to take it to our team of diabetes educators for discussion (as I myself am not an educator or clinician). If they agree that it is a good general recommendation, we will add it to the general list of recommendations.
Have you found any recommendation that you thought was interesting and appropriate?
Thanks again for all the comments!
I try to read the recommendations as a "novice" but after 39 years with diabetes, there is very little that is new. The Rule of 15 has been the standard treatment for hypoglycemia since carbs started being counted. The app suggested I check my glucose tablets to figure out how many carbs each contained. I found this amusing because I would be hard pressed to find a glucose tablet that contained anything besides 4 grams of carbs. There is one that contains 5 grams called Diachieve but they are not available anywhere but online. The problem with this rule is it does not take into consideration how hypoglycemic the patient is. I treat a "hypo" of 40 differently than I treat one of 70. For me 1 gram of carbs increases my blood sugar by 4 points. Each glucose tablet therefore increases me by 16 points. If I treat with 15 grams of carbs I will increase by 60 points. My focus is on avoiding the roller coaster that happens when over-treating hypoglycemia.
Another thing I found amusing under the goals section is I was researching my after breakfast lows - and the suggestion said "I sometimes drink alcohol".I suppose that could be a potential reason for post breakfast hypoglycemia, but gawd I usually wait at least until noon :).
My target blood sugar on my insulin pump is 85. My target range before meals is 70-110 and after meals is 70-140. This is stable and does not change. It was set by me with the approval of my endo/CDE.
One recommendation that was appropriate for me is to have some protein with my meal to avoid drops. I have started putting peanut butter on my toast in the morning which has smoothed out the post breakfast blood sugars.
I think this app basically is good for the average pwd. It sticks to the ADA guidelines and for those who do not have access to CDE's or endos it gives some things to work on to improve control and graphic images of blood sugars. I don't know necessarily if 3 days is enough to accurately represent the trends for decision making. I usually look at 7 days worth of data from my CGM before making any changes to my care.
Clare (with an E but without and I)
Ah, apologies for the name confusion (I often get my own name misspelled and I know how annoying this could be).
Thank you again for your very insightful comments! I can see that after 39 years there is not much that you find new or surprising. But it looks like you were able to find at least one recommendation that was useful; glad to hear it! I think generally with this application we were targeting individuals who are not quite as experienced and knowledgable as you are, and still have a lot to learn. Do you think you would recommend it to other members of TuDiabetes? What other changes do you think would make it more useful? By the way, are you keeping track of your meals in any way? If so, what do you use for that?
As an additional note, we are preparing a new version of the application that has social features (profiles, comments, etc.) and will make it available to our friends on TuDiabetes in just a couple of weeks. Would love for you to try that one as well!
Thank you again,
Houston we have a problem.
I have been entering data into the MODD for a couple of weeks. I finally set a goal after "inventing" a bunch of after breakfast lows. The app suggested adding a protein to breakfast which makes sense as it will be digested more slowly and therefore maybe smooth out the drops. So I "added" some protein to breakfast and things smoothed out but when I went to mark the "problem" as solved - it said your after breakfast blood sugar average is normal and it went from 146 to 88. I wasn't trying to solve a problem of highs after breakfast, I was trying to solve a problem of lows after breakfast. I guess the app just goes to the last 3 days average but when I set a goal to fix lows and the app reports I have "fixed" my goal by my average blood sugar being lower it is just not helpful at all. I guess I would have to go back every single day and enter the data but I just don't have the time to do this.
From what I gather, the app takes the last 3 days of glucose averages to get a trend. The problem with this approach is normally a change in behavior, insulin dose, diet, exercise or any combination of these things takes longer than 3 days to assess. When I change something in my routine, whether adding a protein at breakfast, or changing a pump setting, basal rate, I:C ratio I usually give it at least a week before declaring it a success or failure. Any sooner than that and I might miss a useful technique to help me improve my control.
For some reason I cannot reply to your last comment, so I am posting my reply here.
Indeed, we do have a problem! It turns out we did not connect the lows with the appropriate logic. Complete oversight on our part. Thank you for catching it! We are fixing it now and it should be all resolved by next week. You are the first user that reported lows (all our current users only report readings with averages too high), so we never caught this before.
As for the time frame, our original plan was to use 7 days as well, but then we found that many of our users were less patient and wanted to see some results sooner. I wonder if perhaps we could find some compromise, for example 5 days. But I agree with you that seeing a true pattern requires longer than 3 days.
As they say patience is a virtue :). And I understand in our very fast paced, "I want it now world", users want instant results and are not willing to wait the appropriate amount of time. Maybe 5 days would be a reasonable compromise. Or maybe one could start establishing trends or goals after 3 days of readings, but then use the next 5 days to declare success or failure ?
I confess that I never use applications designed to help with my diabetes because I feel so overloaded with tracking and entering numbers all day long between my CGM (on which I track carbs, insulin doses and exercise) and my pump that I kind of can't stand also entering them in another place.
That said, I do find the fact that MoDD sends me daily reminder texts really useful, and being able to enter my BG right on the phone, without even opening the mobile app, is priceless.
One of the difficulties I have with the layout of the app is that the BG table is organized around meals (before and after), and I tend to eat many snacks throughout the day, rather than 3 solid meals. I wish it was possible to customize this aspect of the app.
I just signed up and answered the 10 screens of questions. The nature of the questions leads me to believe that the underlying nutritional approach and values differ markedly from mine. For example, I don't believe "whole grains" as a wholesome nutrition for a diabetic that wants to maintain reasonable blood glucose control.
I see diabetes, especially T1D, as a disease of carbohydrate intolerance. I limit my carbohydrate consumption to < 75 grams/day. I don't care if that piece of bread is whole grain or not. I will not eat it because it makes my BGs very difficult to control.
I eat a low carb, moderate protein, and high fat diet. I do not fear saturated fats and think that the "low fat, high carb" standard American diet is a disaster for health. I cannot eat high carb fruit like bananas, melons, peaches and pears because I cannot control the subsequent BGs. I much prefer berries for both their nutrition and more easily controlled post-fruit BGs.
I also must limit my consumption of higher carb vegetables like beans to 1/2 cup tops. I much prefer the broccoli, cauliflower, and cucumbers. Avocados are great to eat, satisfying, and contribute to good BGs.
I'm not sure I want to continue to volunteer as a beta-tester since I disagree with the foundational values of this tool.
Apologies for the late response. The signup questions are really meant to assess the level of individuals' knowledge about nutrition, rather then to make any nutritional recommendations (and the questions are based on scientifically validated tools for assessing nutritional knowledge that are often used in research). All the recommendations come later, once you create an account.
Second, while many ideas for problem-solving in this tool are about diet, there are other important aspect of diabetes self-management. Many ideas in the tool are about physical activity or stress management.
In regards to diet, you bring up an interesting point. After following discussions on TuDiabetes, it becomes pretty clear that there exist many different opinions on what constitutes "healthy" or "diabetes-friendly" diet. However, in this tool we must follow the guidelines established by American Diabetes Association, and American Association of Diabetes Educators. As a result, some users will probably find that some of the ideas in the tool are not consistent with their own. However, what we tried to do is to introduce many different ideas, hoping that everybody will find something that works for them.
Hopefully you will still give it a try, especially since now you can leave feedback and comments on different self-management ideas right there in the tool (if you specify that you are TuDiabetes member during registration).