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Sprout Count: questions for a diabetes specialist nurse

Thank you for looking at this. The first three questions take about five to ten minutes. The rest are there if you have time.

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Please don't include anything that could identify a patient.

What happens to your answers: they come to me, the developer of Sprout Count. I use them only to improve the app and I do not share them. The form is hosted by Tally (tally.so), which stores them for me. Your job title is required so I know what kind of view I'm reading; your name and email are optional. To have your answers deleted, email hello@sproutcount.app.

What the app is

Sprout Count is a free app that works out the carbohydrate in a meal, for children with type 1 diabetes and the grown-ups who look after them. Children use it themselves. It runs in a phone's web browser and can be added to the home screen like an app. There are no accounts.

What it does: adds up the carbs in a meal, one food or drink at a time, from a packet label, a barcode scan, or its own food table.

What it does not do: it does not work out insulin doses, and it never will. The main screen says:

Sprout only works out carbs — nothing else. Always show this number to your parent, carer or diabetes nurse before working out insulin.

Privacy: everything stays on the phone. The only thing the app looks up is a barcode number: when one is scanned, and again later if Open Food Facts had no name for that product yet. A family can choose to send a meal to another grown-up as a link, or print a record. Nothing about the child or their meals is ever sent by the app itself.

Words used below:
• Sprout: the app's cartoon sprout. The app's messages to the child are in Sprout's voice, for example "Sprout guessed the carbs".
• Typical figure: the app's own carbs per 100g for a food, taken from CoFID, the UK government's food tables (McCance and Widdowson). It is used when there is no label.
• Range: the "probably between" figures the app works out, because it can't know the exact carbs.
• Meal Record: what a parent or carer sees when the child sends them the plate as a link (the "Edit & Share with Caregiver" button).
• My Meals: the list inside the app of meals already logged, which the child or family can look back through.
• Clinic record: the history of logged meals, which a family can print or save from "Export & Clinic Records".

The welcome screen (which has to be agreed to before the app can be used), the Meal Record and the clinic record all say the figures are an estimate and that the app is not an insulin dose calculator.

Why I'm asking: the sums have been tested thoroughly. What no one clinical has checked is whether the numbers are shown in a way that helps rather than misleads. That's the part I can't judge.

Short on time? These three matter most

1. Is showing a range helpful, or does it invite trouble?

Sprout Count plate. Pizza, 150g weighed, at the typical 30g per 100g: 45g, marked "a guess". Total Plate 45g. Under "For grown-ups": probably 32.7 to 56.7g.
In the app: 150g of pizza on the plate, with "For grown-ups" tapped open.
The app can't know the exact carbs, so as well as one figure it works out a likely range.

In the picture: 150g of pizza, weighed on scales, with no label. The app used its typical figure for pizza, 30g per 100g, so the pizza comes to 45g.
• The child sees one number: 45g. The top of the plate says "about 45g so far" and "has a guess", and the pizza is marked "a guess", because its carbs came from the app, not from a label.
• Under the total, "For grown-ups" opens the range: probably 32.7–56.7g.
• The range is wide because pizzas vary: the app's food table has pizzas from about 23g to 36g of carbs per 100g. If the same 150g had been weighed and the carbs read off a label, it would say probably 42.7–47.3g.

The range also shows in the "why?" note on each guessed food, on the Meal Record, and on the clinic record for guessed foods.

The worry: someone gives insulin for the top of the range, "to be safe".

Is a range useful to a parent or carer, or would one number be safer?

A
B
C

Question 1: your notes

2. Is one decimal place honest, or false confidence?

The app shows carbs to one decimal place when there is one: the range in the picture above (32.7–56.7g), for example, or 46.7g for 146g of rice at 32g per 100g.

I understand carb counting is often taught rounded, to the nearest 5g or 10g.

Does one decimal place suggest the figure is more exact than it really is? Would rounding be more honest?

A
B
C
D
E

Question 2: your notes

3. Are these three choices clear?

How much are you having? 150 grams. How did you work it out? Three buttons: The packet told me, I weighed it, I guessed.
In the app: after the amount, "How did you work it out?" and its three buttons.
After the amount, the app asks "How did you work it out?". It asks this for every food except bread slices (see question 13). The answer sets how wide the range is:
• 📦 The packet told me: the weight is printed on the pack. Range ± 3%.
• ⚖️ I weighed it: weighed on kitchen scales. Range ± 5%.
• 👀 I guessed: judged by eye. Range ± 25%.

On the plate and on the Meal Record, a food that was guessed, or that used the app's typical figure instead of a label, is shown in amber.

Do these words mean to you what they're meant to mean? Does "I guessed" nudge people to weigh instead, or could it put them off logging at all?