Mr Eddie Tan, who has Type 1 diabetes, with the Buzud app and a continuous glucose monitor on his arm. He said that the introduction of the insulin calculator would enable him to “get more adventurous” with food. ST PHOTO: NG SOR LUAN
The Straits Times (10 March 2025)
Tan Tock Seng Hospital (TTSH) and biomedical technology company Buzud are working on an AI or artificial intelligence-enabled tool in an app to help diabetes patients accurately calculate their correct insulin dosage before a meal.
Using an AI-trained camera feature
in the app, a patient would
snap a picture of his food. The app
would then identify meal components
in the picture and use data
from the patient’s wearable continuous
glucose monitor (CGM) to
perform the calculations.
Most diabetic patients today estimate
the amount of insulin they
should jab before their meals, said
senior nurse clinician Lian Xia
from TTSH’s Department of Endocrinology.
“This has been the way for a long
time because there is no simpler
way to do it,” said Ms Lian, who is
spearheading the project on the
hospital’s end.
She shared that patients of the
endocrine clinic often experience
anxiety over miscalculation of insulin
doses, especially among
those newly diagnosed or adjusting
to their need for multiple daily
injections.
Patients with Type 1 diabetes, advanced
Type 2 diabetes, gestational
and pancreatogenic diabetes are
required to either perform calculations
before their meals to know
the precise amount of insulin to
self-administer before eating, or
make a guess based on meals they
previously had.
Insulin dose calculation involves
a measurement of all the carbohydrates
in the meal before performing
a finger-prick test to determine
the patient’s excess blood glucose
levels.
Patients would then need to determine
how many additional units
of insulin are needed to counter
any excess glucose and sum up the
total amount of insulin required.
This test has to be done multiple
times a day.
In 2024, a team of 20 dieticians,
nurses, endocrinologists and medical
social workers from TTSH
started working with the developers
of the app, which is also called
Buzud, to refine the accuracy of
the app’s image recognition.
The calculation tool will be
launched only when it achieves
99.9 per cent accuracy.
Over the next two years, the
meal recognition camera will undergo
refinement and clinical trials
as the two partners further train
the accuracy of the AI to attain that
level of accuracy.
Trained on Western and a large
number of Asian dishes, it currently
has an accuracy of about 90 per
cent, according to Mr Frankie Fan,
chief executive of Buzud.
Its current limitations include
the inability to detect some sauces
and condiments, as well as ingredients
that are small in size or
quantity.
“The camera could fail to pick up
small amounts of noodles, for example,
or mistake it for something
else, because of its small quantity,
or the angle at which the photo was
taken. Factors like lighting affect
the outcome, too,” Mr Fan said.
TTSH nurses will continue feeding
Buzud information on the nutritional
needs of diabetic patients
and up to 600,000 more images of
foods captured through clinical
trials, he added.
Ms Lian said: “By contributing to
the development of an intuitive,
AI-enhanced tool, we hope to
bridge the gap between clinical
care and real-time decision-making
at mealtimes.”
No changes will be made to the
glucose monitor, which can be selffitted
by the patient and has a lifespan
of 15 days.
The monitor – a device that is attached
to the inside of the forearm
– contains a fine plastic filament
that penetrates the skin in order to
come into contact with the bloodstream.
This filament continuously
takes blood glucose levels which
are relayed live, every minute, via
Bluetooth to the Buzud app on the
patient’s mobile phone. Patients
are also alerted to any abnormal
glucose events.
The health management app was
launched in 2022, and currently
has about 520,000 users across
Singapore, Malaysia and Indonesia.
While the monitor and a basic
version of the AI-enabled food recognition
are currently available,
the insulin calculator is expected
to be launched in 2027.
Ms Lian said: “We hope this digital
solution will empower the patients
to reduce the risk of hypoglycaemia
(low blood sugar) and hyperglycaemia
(high blood sugar). It
might potentially reduce emergency
visits and hospital admissions,
too.”
Mr Eddie Tan, 47, is a Type 1 diabetes
patient of 15 years. He said
that his active lifestyle as a sailing
coach requires him to prick his fingers
10 times or more a day – before
and after training and meals, and
before bed.
Despite having quite a healthy
appetite for food, Mr Tan said he
has avoided trying new foods, opting
instead for familiar food choices
to avoid having to go through the
ordeal of pin pricks and calculations.
The Buzud app and CGM-user of
one year said that the introduction
of the insulin calculator would enable
him to “get more adventurous”
with food, as he could widen
his repertoire of food without having
to worry about calculating the
correct amount of insulin before
eating.
“It is nice to know that with everything
consolidated on my phone,
and (updates) provided in real
time, I can rectify things immediately
and accurately in times of episodes.
remely
helpful in reducing episodes
of hyperglycaemia and hypoglycaemia,”
Mr Tan said.