Abstract
Introduction: This study aimed to identify popular diabetes applications (apps) and to investigate the association of diabetes app use and other factors with cumulative self-care behaviour.Methods: From November 2017 to March 2018, we conducted a web-based survey with persons 18 years of age and above. We recruited respondents via diabetes Facebook groups, online patient-forums and targeted Facebook advertisements (ads). Data on participants' demographic, clinical, and self-management characteristics, as well as on self-care behaviour and characteristics of the diabetes apps use were collected. Self-care behaviour was measured using a licensed version of the Summary of Diabetes Self-care Activities (SDSCA) questionnaire. The cumulative self-care score was calculated by summing up scores for “general diet,” “specific diet,” “exercise,” “blood glucose testing,” “foot care” and “smoking.” To identify popular diabetes apps, users were requested to list all apps they use for diabetes self-management. Two sample t-test and multiple linear regression stratified by type of diabetes were performed to examine associations between app use and self-care behaviour, by controlling for key confounders.Results: One thousand fifty two respondents with type 1 and 630 respondents with type 2 diabetes mellitus (DM) entered the survey. More than half, 549 (52.2%), and one third, 210 (33.3%), of respondents with type 1 and 2 DM, respectively, reported using diabetes apps for self-management. “mySugr” and continuous glucose monitoring apps, such as “Dexcom,” “Freestyle Libre,” and “Xdrip+” were some of the most popular diabetes apps. In both respondent groups, the cumulative self-care behaviour score was significantly higher among diabetes app users (compared to non-users) and scores for three individual self-care components, namely “blood glucose monitoring,” “general diet,” and “physical activity” were significantly higher among diabetes app users than among non-users. After adjusting for confounding factors, diabetes app use increased the cumulative self-care score by 1.08 (95%CI: 0.46–1.7) units among persons with type 1 DM and by 1.18 (95%CI: 0.26–2.09) units among persons with type 2 DM, respectively.Conclusion: For both, persons with type 1 and type 2 diabetes, using diabetes apps for self-management was positively associated with self-care behaviour. Our findings suggest that apps can support changes in lifestyle and glucose monitoring in these populations.
Highlights
This study aimed to identify popular diabetes applications and to investigate the association of diabetes app use and other factors with cumulative self-care behaviour
A total of 1682 complete responses were received from respondents with type 1 or type 2 diabetes who owned a smartphone
We looked at the differences between app users and non-users regarding the individual self-care components, we did not examine the factors for each individual self-care component
Summary
This study aimed to identify popular diabetes applications (apps) and to investigate the association of diabetes app use and other factors with cumulative self-care behaviour. In addition to medical treatment, effective interventions promoting healthy behaviour are important aspects of diabetes care [6,7,8]. Blood glucose monitoring, and optimal adherence to medication and recommendations for a balanced diet are integral to effective diabetes self-management [9, 10]. Evidence suggests that diabetes applications (apps) support patients in advancing their knowledge of the disease, including awareness of complications and their personal self-management capabilities [16,17,18,19,20]. Additional apps were shown to support patients in reducing high or low glycemic abnormalities, improving treatment satisfaction, and self-care behaviour [31]. The rapid progress of internet of things, big data analytics, machine learning, artificial intelligence and other advances in mobile computing [34] are revolutionizing the future of personalized diabetes medicine
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