Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Oct 17, 2025
Open Peer Review Period: Oct 20, 2025 - Dec 15, 2025
Date Accepted: Feb 25, 2026
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Designing a Carbohydrate Counting App for Young Adults With Type 1 Diabetes: Usability Testing Interview Study

Housni A, Shulkin A, Katz A, Giannini G, Roy-Fleming A, Nakhla M, South C, Brazeau AS

Designing a Carbohydrate Counting App for Young Adults With Type 1 Diabetes: Usability Testing Interview Study

J Med Internet Res 2026;28:e86024

DOI: 10.2196/86024

PMID: 41915692

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Usability Testing of A Carbohydrate Counting Application designed For and With Young Adults with Type 1 Diabetes

  • Asmaa Housni; 
  • Aidan Shulkin; 
  • Alexandra Katz; 
  • Giuliana Giannini; 
  • Amélie Roy-Fleming; 
  • Meranda Nakhla; 
  • Courtney South; 
  • Anne-Sophie Brazeau

ABSTRACT

Background:

Carbohydrate counting assists people with type 1 diabetes (T1D) adjust mealtime insulin doses, however, it is often burdensome. Mobile applications can simplify this process by automating carb estimation and insulin calculations, yet no comprehensive solution currently combines photo-based carb recognition with an integrated bolus calculator.

Objective:

This study aimed to optimize a novel app designed to support young adults with T1D in carbohydrate counting and insulin dosing by incorporating feedback from usability testing.

Methods:

We used a think-aloud protocol and conducted four rounds of interviews, each with 3–5 participants, to assess effectiveness of the app and identify areas for improvement.

Results:

A total of 18 completed the usability testing. Thematic analysis revealed seven key insights; 1) A person-centered design is important for an individualized experience, addressing the individual as a whole, not just their diabetes; 2) An intuitive user interface is essential to maintain engagement, with clear information presentation and easy interaction; 3) The relevance of information, should be presented in familiar language to enhance identification and inclusion; 4) Personalized features for a tailored user experience; 5) Robust data verification mechanisms and override abilities to avoid human and technological errors; 6) A comprehensive application to improve patient-practitioner communication and reduce manual tracking or the use of multiple apps; 7) Linkage of various factors (exercise, diet, time of injection) to glucose levels could improve self-efficacy and promote personalized learning.

Conclusions:

This will be the first Canadian app to combine carbohydrate counting and insulin dosing while involving end users in its development.


 Citation

Please cite as:

Housni A, Shulkin A, Katz A, Giannini G, Roy-Fleming A, Nakhla M, South C, Brazeau AS

Designing a Carbohydrate Counting App for Young Adults With Type 1 Diabetes: Usability Testing Interview Study

J Med Internet Res 2026;28:e86024

DOI: 10.2196/86024

PMID: 41915692

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.