Real-World Follow-Up of People With Type 2 Diabetes Using a Mobile Diabetes App With Connected Glucose Meters Finds Improvements in Glycemia Are Durable Over 5 Years

Abstract

Objective:

Evidence from long-term, real-world use of blood glucose (BG) monitoring technologies is sparse. We investigated whether using a diabetes app with connected meters could support durable diabetes management improvements in people with type 2 diabetes (T2D) over 5-years.

Methods:

Anonymized glucose and app analytics from 501 people with T2D were extracted from our server. The first 14 days using the app were compared with the last 14 days of each consecutive year for 5 years, using paired within-subject differences. Subjects had ≥365 BG readings per year.

Results:

People with T2D improved BG readings in range (RIR, 70-180 mg/dL) by +6.9 percentage points (%pts, 74.6% to 81.5%) and readings in tight range (RITR, 70-140 mg/dL) by +7.8%pts (49.2% to 57.0%) at year 1. Year 1 improvements in RIR and RITR remained evident at year 5 (+7.5%pts and +7.7%pts, respectively). Reductions in hyperglycemic readings (>180 and >250 mg/dL) explained the improvements in RIR and RITR over the 5-years. Mean BG reduced by -9.1 mg/dL at year 1 (150.2 to 141.1 mg/dL) and this was sustained at year 5 (-10.6 mg/dL, 150.2 to 139.6 mg/dL). Subjects performed BG checks at a consistent level, equivalent to 1.8 to 2.1 checks per day, over 5 years. All these glycemic changes were significant (p<0.001). Higher app engagement (>4 app sessions per week) effected better diabetes management.

Conclusion:

Real-world follow-up of people with type 2 diabetes using a diabetes app with connected meters found improvements in glycemia were durable over 5-years.