Transitioning from SMBG to CGM in Combination with a mHealth App Improves Glycemic Control in People with Type 1 and Type 2 Diabetes.

Abstract

Integrating mobile health (mHealth) apps into daily diabetes management allows users to monitor and track their health data, creating a comprehensive system for managing daily diabetes activities and generating valuable real-world data. This analysis investigates the impact of transitioning from traditional Self-Monitoring of Blood Glucose (SMBG) to real-time continuous glucose monitoring (rtCGM), alongside the use of a mHealth app, on users' glycemic control. Data was collected from 1,271 diabetes type 1 and type 2 users of the mySugr® app who made a minimum of 50 SMBG logs one month before transitioning to rtCGM and then used rtCGM for at least six months. The mean and coefficient of variation (CV) of glucose, along with the proportions of glycemic measurements in and out of range were compared between baseline and 1, 2, 3, and 6 months of rtCGM use. A mixed-effects linear regression model was built to quantify the specific effects of transitioning to a rtCGM sensor in different subsamples. A novel validation analysis ensured that the aggregated metrics from SMBG and rtCGM were comparable. Transitioning to a rtCGM sensor significantly improved glycemic control in the entire cohort, particularly among new users of the mySugr app. Additionally, the sustainability of the change in glucose in the entire cohort was confirmed throughout the observation period. People with type 1 and type 2 diabetes (T1D and T2D) exhibited distinct variations, with T1Ds experiencing a greater reduction in glycemic variance, while T2Ds displayed a relatively larger decrease in monthly averages.