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Mobile phone apps for blood sugar control

The Bottom Line

  • Diabetes is one of the top contributors to the annual global death count. 
  • Mobile phone apps for lifestyle modification can help to reduce average blood sugar levels in people with type 2 diabetes, but their impact on pre-diabetes and type 1 diabetes remains unclear. 
  • Consider adding a mobile health app to your type 2 diabetes self-management plan. Do your homework on what the app entails, read user reviews, and consult with your health care provider about how best to integrate this strategy into your treatment plan and any safety concerns. 
 

Be it a smartphone, smartwatch, tablet, or laptop. When it comes to technology, many of us frequently hear that we are too “plugged in”. Although exercising moderation around the use of our favorite devices is important, research has shown that we can also lean on technology to support our healthy aging goals. Assistance with medication management, providing avenues to socialize and connect with others, facilitating access to health information, and helping folks keep focused and motivated as they work toward personal goals such as smoking cessation or weight loss are just a few examples of how being “plugged in” can be valuable (1-4).


But does this value extend to those who are diagnosed with or are at risk of diabetes, one of the leading causes of death globally (5)?


We can turn to a recent systematic review about the effect of mobile phone apps on various diabetes subtypes for guidance (6). The three types of diabetes highlighted in this review include: prediabetes (a condition where blood sugar levels are elevated, thereby increasing the risk of developing type 2 diabetes), type 1 diabetes (a disease in which a person’s immune system attacks cells that produce insulin), and type 2 diabetes (a disease associated with poor nutrition, excess weight, and low activity levels) (6-9). Given that adopting a healthy lifestyle is a key treatment strategy across diabetes subtypes and a preventive strategy for prediabetes and type 2 diabetes, it is no surprise that the mobile phone apps studied focused on lifestyle modification. App features varied, but examples include the monitoring of diet and exercise behaviours, support for adjusting medications, feedback from health care provides, and cognitive strategies to boost motivation (6).


What the research tells us

The most promising results are for type 2 diabetes. More specifically, the review found that mobile apps for lifestyle modification can lower average blood sugar levels in people with type 2 diabetes. These reductions occurred both in the short-term (3-6 months) and the long-term (9-12 months). Unfortunately, the results for pre-diabetes and type 1 diabetes were not as positive or as convincing. In people with prediabetes or type 1 diabetes, using these mobile apps does not appear to have an effect on average blood sugar levels in the short-term. No comment can be made on the long-term effect for prediabetes because there was no data for this outcome. On the other hand, a decrease in average blood sugar levels may occur in the long-term for people with type 1 diabetes, but this finding was based on just one study and therefore more research is needed before definitive conclusions can be made.


These results point to the need for more research in two areas. The first being the intersection between mobile app usage and prediabetes and type 1 diabetes. The second being the effectiveness and safety of these apps past a one year period (6).


For folks with type 2 diabetes, the addition of a mobile phone app that supports lifestyle adjustments to your treatment arsenal may be worth a try. Before you dive into this virtual app ocean, there are several considerations to keep in mind: some apps are free while others come at a cost; make sure to compare and contrast multiple apps before settling on one; look at the features offered; read the reviews left by past and present users; and pay attention to any comments about adverse effects or challenges, as app safety is not always adequately evaluated. Don’t forget to connect with your health care provider to discuss your interest in this strategy, perhaps how best to integrate it into your treatment plan, and any concerns over safety that you may have.


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References

  1. Thakkar J, Kurup R, Laba T-L, et al. Mobile telephone text messaging for medication adherence in chronic disease: A meta-analysis. JAMA. 2016; 176:340.349.
  2. Chen YR, Schulz PG. The effect of information communication technology interventions on reducing social isolation in the elderly: A systematic review. J Med Internet Res. 2016; 18(1):e18. doi: 10.2196/jmir/4596.
  3. Whittaker R, McRobbie H, Bullen C, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2016; 4:CD006611. doi: 10.1002/14651858.CD006611.pub4. 
  4. Liu F, Kong X, Cao J, et al. Mobile phone intervention and weight loss among overweight and obese adults: A meta-analysis of randomized controlled trials. Am J Epidemiol. 2015; 181:337-348.  
  5. World Health Organization. Diabetes. [Internet] 2020. [cited February 2021]. Available from https://www.who.int/news-room/fact-sheets/detail/diabetes 
  6. Wu X, Guo X, Zhang Z. The efficacy of mobile phone apps for lifestyle modification in diabetes: Systematic review and meta-analysis. JMIR Mhealth Uhealth. 2019; 7:e12297.
  7. Madsen KS, Chi Y, Metzendorf MI, et al. Metformin for prevention or delay of type 2 diabetes mellitus and its associated complications in persons at increased risk for the development of type 2 diabetes mellitus. Cochrane Database Syst Revs. 2019; 12:CD008558. doi: 10.1002/14651858.CD008558.pub2. 
  8. Tandon S, Ayis S, Hopkins D, et al. The impact of pharmacological and lifestyle interventions on body weight in people with type 1 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab. 2021; 23:350-362. doi: 10.1111/dom.14221.  
  9. Kerblom HK, Vaarala O, Hyoty H, et al. Environmental factors in the etiology of type 1 diabetes. Am J Med Genet. 2002; 115(1):18-29.

DISCLAIMER: Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of these blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations such as social distancing and frequent hand washing. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with current social distancing recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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