Validation of an App in the Elderly Population With Diabetes Mellitus. (SMARTDIABETES)

The SMART-DIABETES app will be installed on your mobile phone for use for 4 months (+/- 15 days). Initially, the participants will receive specific information and training on how to use the app.

The application will have three specific sections:

1. A personalized physical exercise program (16-18 weeks) designed based on the participant's initial physical condition.
2. Dietary advice consisting of daily diets to be followed throughout the study, individualized according to the baseline nutritional assessment.

3. Records and monitoring: Blood glucose, food, medication, activity, HbA1c (with a minimum of 3 daily blood glucose logs for 3 months, it can calculate the estimated HbA1c), weight, heart rate, ketones.

   • Bolus calculator: quick insulin dose recommendations.
   • Digital diary that includes all recorded readings.
   • Carbohydrate calculator: the patient can calculate the number of carbohydrates they will ingest in grams or servings.
   • Nutritional da

• The SMART-DIABETES app

Glycemic control:

1. Glycated hemoglobin, considering the target of achieving between 7 and 8.5%
2. Number of hypoglycemic episodes (assessed by the number of symptomatic/asymptomatic hypoglycemic episodes per month)

Assess the functional status of participants according to

• FTS-5 (Frailty Trait Scale-5) Scale ranging from 0 to 50, with a score of 30 or higher considered risky to disability
• SPPB (The Short Physical Performance Battery) (Score of SPPB scale) 0-4 points: Severe limitation of mobility. 4-6 points: Moderate limitation. 7-9 points: Mild limitation. 10-12 points: Minimal limitation.

Assessed through a general questionnaire

• EuroQol-5D (European quality of life measure) The questionnaire describes the current health status of individuals across five dimensions: mobility, self-care, daily activities, pain/discomfort, and anxiety/depression. Each of these dimensions has five possible responses or levels of severity: no problems (1), mild problems (2), moderate problems (3), severe problems (4), and extreme problems/impossibility (5).
• ADDQoL (Auditing Diabetes Quality of Life) - Scores range from -9 to +3. A negative score indicates that diabetes is having a harmful effect on that part of your life.

Usability test of the app by patients, families, and healthcare professionals

Score of usability > 80.3: A (Excellent). Users love the system and will recommend it. 68 - 80: B/C (Good/Acceptable). The system is usable, but there is room for improvement.

51 - 67: D (Poor/Acceptable). The system has significant usability problems. < 50: F (Unacceptable). The system is very difficult to use.

• The Technology Acceptance Model (TAM) questionnaire assesses user acceptability of new technology through two primary constructs-Perceived Usefulness (PU) and Perceived Ease of Use (PEU) usually measured on a 5- or 7-point Likert scale. High scores indicate stronger intent to adopt technology, typically with PU having a stronger correlation to usage
• The User Experience Questionnaire (UEQ) Measures user experience across six scales (Attractiveness, Perspicuity, Efficiency, Dependability, Stimulation, Novelty) Scores from -3: Extremely negative Scores Between -0.8 and 0.8: Considered neutral (average). Scores > 0.8: Positive. Scores > 3: Extremely positive

Adverse events during the use of the APP

• Number of total hospitalizations
• Number of emergency room visits
• Total days in hospitalization
• Death