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App Users Report Lower Blood Glucose Levels

Meter, watch, phone apps

One Drop glucose meter, at top left, with watch and smartphone apps (One Drop)

25 August 2017. A study of individuals with diabetes using a mobile app to record blood glucose levels, reported more than a 1 percent average reduction in blood glucose readings after a median of 4 months. Results of the study, conducted by Informed Data System Inc. in New York, makers of the app One Drop, appear in yesterday’s issue of the journal JMIR Diabetes.

Diabetes is a chronic disorder where the pancreas does not create enough insulin to process the sugar glucose to flow into the blood stream and cells for energy in the body. In type 2 diabetes, which accounts for at least 90 percent of all diabetes cases, the pancreas produces some but not enough insulin, or the body cannot process insulin. Type 1 diabetes is an autoimmune disorder where the immune system is tricked into attacking healthy beta cells in the pancreas that produce insulin. According to the International Diabetes Federation, diabetes affects an estimated 415 million people worldwide, of which 44 million are in North America.

The study, led by Chandra Osborne, the company’s vice president for health and behavioral informatics, collected data from 1,288 individuals with diabetes using the One Drop app. One Drop offers a diabetes management system with a glucose meter, lancing device, and test strips similar to other devices for measuring blood glucose levels. The company also offers a mobile app — available in iPhone, Android, and smart watch versions — that imports data from the company’s glucose meter, as well other digital glucose meters. In addition, the app reminds users to take medications, tracks medications taken, and monitors insulin pump basal rates, the ongoing minimal delivery of insulin to the blood stream.

Osborne and colleagues asked participants in the study — 921 with type 2 and 367 with type 1 diabetes — to provide data from their apps after they first created a One Drop account, then again about 3 months later. The second report in some cases stretched out to 12 months after the first measurements, but the median interval between the 2 readings was 4 months. Participants provided blood glucose levels, also known as glycated hemoglobin or HbA1c, as well as extent to which they used other self-care features on the app, such as recording their food consumption.

The results show blood glucose levels dropped on average slightly more than 1 percent (1.07%) for participants overall. People with both types of diabetes showed improvements from the first to second blood glucose reports, but those with type 2 diabetes experienced somewhat greater decreases on average, 1.27 percent, compared to reductions of 0.9 percent for type 1. Participants used the self-care features of the app nearly 1,650 times between the 2 reports. Individuals tracking their diets, one of the self-care features, reported larger blood glucose decreases than participants not recording their food intake.

Participants in the study were users of the One Drop app, taking part in a retrospective data collection and analysis, not a controlled experiment. No comparisons were made with users of other diabetes management apps or people not using mobile devices as part of their diabetes care.

Using the mobile app as a data collection system, however, provides important advantages over earlier studies of the technology to manage diabetes. First, the authors note they could collect data on a larger group of participants, where previous studies relied on much smaller samples. Second, the team collected its data from the apps in early June 2017, with the data published in late August. “From study to publication in less than 3 months is unheard of,” says Osborne in a company statement. “When it comes to technology, relevance and speed are everything.”

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