{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:50:23Z","timestamp":1753890623530,"version":"3.41.2"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Individuals living with type 1 diabetes are at risk of long-term complications related to chronic hyperglycemia. Tight glycemic control is recommended but can increase the risk of iatrogenic hypoglycemia. Hedia Diabetes Assistant (HDA) is a bolus calculator that provides users with bolus insulin recommendations based on personalized settings. We aimed to investigate the effects of HDA on a known risk index of hypoglycemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>New users from 2019 to 2021 were included if they fulfilled the following criteria: age \u226518 years, \u22655 logs\/1st week of use, and \u22651 log for glucose, carbohydrate, and insulin. User data was extracted from the HDA database. The prespecified primary endpoint was change in the Low Blood Glucose Index (LBGI) after 12 weeks of use. Secondary endpoints were changes in the High Blood Glucose Index (HBGI) and eA1c. An exploratory endpoint was to maintain potential improvements in LBGI after 25 weeks. A repeated-measures mixed model with a log-transformation was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,342 users were included. The mean age was 43.4 years (SD 14.7) with 52.3% being female. After 12 weeks, LBGI significantly improved from 0.73 to 0.61 (17% decrease, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001) with no significant changes in HBGI, and eA1c. From week 12 to 25, LBGI decreased from 0.61 to 0.55 (10%, <jats:italic>P<\/jats:italic>\u2009=\u20090.107).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Users of HDA experienced statistically significant improvement in LBGI after 12 weeks with no changes in HBGI and eA1c, which was successfully maintained after 25 weeks. These results suggest a decreased risk of hypoglycemia when using HDA.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fdgth.2025.1430744","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T12:36:07Z","timestamp":1743078967000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical performance of Hedia Diabetes Assistant bolus calculator for diabetes management: a real-world retrospective cohort study"],"prefix":"10.3389","volume":"7","author":[{"given":"Kenney Fehrenkamp","family":"Pedersen","sequence":"first","affiliation":[]},{"given":"Anne","family":"\u00d8sterskov","sequence":"additional","affiliation":[]},{"given":"Sabrina Mai","family":"Nielsen","sequence":"additional","affiliation":[]},{"given":"Gkikas","family":"Karagkounis","sequence":"additional","affiliation":[]},{"given":"Astrid Karn\u00f8e","family":"Knudsen","sequence":"additional","affiliation":[]}],"member":"1965","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S111","DOI":"10.2337\/dc24-S006","article-title":"6. Glycemic goals and hypoglycemia: standards of care in diabetes-2024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1111\/dom.15521","article-title":"The effect of bolus advisors on glycaemic parameters in adults with diabetes on intensive insulin therapy: a systematic review with meta-analysis","volume":"26","author":"den Brok","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1177\/1932296814532906","article-title":"Bolus calculators","volume":"8","author":"Schmidt","year":"2014","journal-title":"J Diabetes Sci Technol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/S2213-8587(17)30014-1","article-title":"Exercise management in type 1 diabetes: a consensus statement","volume":"5","author":"Riddell","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1177\/1932296815599177","article-title":"Are risk indices derived from CGM interchangeable with SMBG-based indices?","volume":"10","author":"Fabris","year":"2015","journal-title":"J Diabetes Sci Technol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1136\/bmj.312.7038.1079","article-title":"Statistics notes: transformations, means, and confidence intervals","volume":"312","author":"Bland","year":"1996","journal-title":"Br Med J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.2337\/diacare.21.11.1870","article-title":"Assessment of risk for severe hypoglycemia among adults with IDDM: validation of the low blood glucose index","volume":"21","author":"Kovatchev","year":"1998","journal-title":"Diabetes Care"},{"key":"B8","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.cca.2012.12.026","article-title":"The long and winding road to optimal HbA1c measurement","volume":"418","author":"Little","year":"2013","journal-title":"Clin Chim Acta Int J Clin Chem"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1093\/eurheartj\/ehp039","article-title":"Glycaemic control in newly diagnosed diabetes patients and mortality from ischaemic heart disease: 20-year follow-up of the HUNT study in Norway","volume":"30","author":"Dale","year":"2009","journal-title":"Eur Heart J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e35120","DOI":"10.2196\/35120","article-title":"Challenges in participant engagement and retention using Mobile health apps: literature review","volume":"24","author":"Amagai","year":"2022","journal-title":"J Med Internet Res"}],"container-title":["Frontiers in Digital Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2025.1430744\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T12:36:10Z","timestamp":1743078970000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2025.1430744\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":10,"alternative-id":["10.3389\/fdgth.2025.1430744"],"URL":"https:\/\/doi.org\/10.3389\/fdgth.2025.1430744","relation":{},"ISSN":["2673-253X"],"issn-type":[{"type":"electronic","value":"2673-253X"}],"subject":[],"published":{"date-parts":[[2025,3,27]]},"article-number":"1430744"}}