You may remember that back in September 2018 we helped the AADE (American Association of Diabetes Educators) run a survey on app use among people with diabetes (PWDs).

Their questionnaire focused on: Which apps do PWDs find most valuable, and which do they wish diabetes educators knew more about?

That Fall survey garnered nearly 200 responses, providing interesting insight on which apps seem more appealing and why, what motivates patients to use them, and how PWDs’ app preferences* may differ from those of diabetes educators – when comparing apps recommended by both groups.

Educators were given the same survey but without any comment sections, with the goal of cross-referencing to select 30 apps to be reviewed and included for 2019 in AADE’s new DANA technology platform.

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{*Do remember that 30 apps are already reviewed and appear in the DANA platform, including popular names like Accu-Chek, Fitbit, Glooko, My Fitness Pal, mySugr, One Drop and Tidepool – which may have affected educators’ choices, as they were seeking new titles not already reviewed.}

Here’s a rundown of the results:

 

Food / Carb Tracking Apps 

58% of patients queried said they use an app for food logging or carb counting. The top 5 apps respondents said they’re using for this purpose are:

  • My Fitness Pal
  • One Drop
  • Calorie King
  • Loop
  • mySugr

The educators’ picks included Weight Watchers, LoseIt, Spark People, Glucosurfer and Carb Manager.

In the Comments section, patients were asked to rank and remark on the reasons they chose the apps they did, by:

  • Features/ Functions
  • Ease/ Usability
  • Recommended
  • Linked/ Integrated/ Compatibility
  • or Other

Some of the benefits swaying them on food apps included:

Best user interface, best experience, biggest food library, syncs w/ everything.

Has pre programmed foods and remembers my regular everyday food stuff.

Love how it looks, tons of features and great support.”

It interfaces with Apple Health and with my insulin pump.”

and specifically one person noted:

Sugarmate has a graph you can manipulate to see every moment of every day and review BG readings for every update.

Several people said the app they chose was recommended by a friend or relative, but quite a few also said the recommendation came from a doctor or nutritionist.

 

Fitness Tracking Apps

The group was split pretty evenly on fitness tracking app use, with 51% saying yes, and 49% saying no. For those who did, their top 5 picks were:

  • Apple Health
  • Fitbit
  • My Fitness Pal
  • One Drop
  • Samsung Health

That last pick was the biggest surprise to me personally, not knowing that the Samsung Health app was so highly regarded.

The educators also listed Samsung Health as a top pick, along with ILoveFitness, StepTracker and FitScript. 

One of the top reasons patients gave for their choice of fitness app was “it came installed on the phone” (!). So kudos to the phone vendors for this win-win move.

Other reasons patients gave for their selections were:

Compatibility with smart watch, which makes it passive on my part.”

It not only tracks my fitness progress but my blood sugar levels as well and the workouts are tailored to where my blood sugar is doing at that moment.

It provides great amount of techniques for best desired results.”

Fitbit in particular got a lot of praise for its simplicity and ability to wirelessly upload data to a computer for further review.

 

BGM / CGM Tracking (Data Logging and Analysis)

66% of respondents in this group said they use an app for tracking their glucose data, either from a fingerstick meter or CGM. Their top picks were:

  • Dexcom Clarity
  • One Drop
  • Tidepool
  • One Touch
  • Dexcom (G5)

The educators’ list included Medtronic CareLink, Tandem t:connect, Dexcom Share, Contour and Diasend.

An obvious reason for patient choice was apps that are connected to the device they use, which was not always a plus, as several folks noted:

Only one available, proprietary.”

Not a choice.

Only option. It's a truly terrible app.

 

Other Health Apps for Diabetes

Only 37% of respondents said they use “other apps” to manage their diabetes. For patients, the top 5 mentions included some that fell in previous categories:

  • Beyond Type 1
  • Nightscout
  • MySugr
  • Tidepool
  • Dexcom Clarity

The educators “other” picks also included Beyond Type 1, along with Glucose Buddy, GlucoseZone, GoodRX, Diabetes360 and Headspace, a beginners meditation and mindfulness app.   

In the Comments section, numerous patients mentioned the importance of a sense of community, provided in this case by the Beyond Type 1 app:

It’s a great social network to interact with other diabetics and help each other.”

Being together and connecting with people whom are like minded helps us progress from what we know of and that which we know not of.”

It gives me so much support when all I want to do is die.” (wow…)

Also, in regards to the grassroots patient-community-created Nightscout remote BG monitoring app:

Nightscout contains great reports that help with my treatment analysis. It is available from any device: phone, laptop, or iPad. It talks to my Loop app and Dexcom CGM and tracks my glucose trace, food intake, insulin doses, and the actual basal delivery that tracks changes to my basal rates that can change every five minutes.”

NOTE that the DIY Loop app also showed up many times in this survey, but since it directs insulin dosing and is not yet FDA approved or in the app stores, AADE is unable to review it at this time. That should change soon now that Tidepool is working to “product-ize” Loop.

 

Diabetes Apps: Frustrations and Praise

Overall, patients expressed that they want their diabetes educators to know the basic offerings and ideally have some hands-on experience to share.

Comments indicated that educators should know:

 “That these apps exist and in what situations they could be helpful to patients.

The benefits they have.

Features available and how to best take advantage of them.

 “Enough to provide information on 1-2 which may assist in a specific problem I am trying to fix.

The ways they work together to gather info and document it for tracking.

 

People also expressed some basic frustrations:

My doctor's office can't download my pump or CGMS data, which is frustrating. Therefore, my endocrinologist has less information at my appointment than when I kept paper records.”

I wish they integrated more easily. Apple Health holds all of my insulin delivery and CGM data - I wish more apps could read this data and make meaningful insights / products out of it. Right now everything is very sandboxed and closed off.

 

And they also cheered on the apps they feel have truly helped them:

It's informative, encouraging, works with blood sugar levels and fun.”

The coaching is helpful between appointments.”

The doctor could see my entries and help me take better life decisions to keep glucose under control.”

In this section, there was a lot of praise specifically for One Drop, with its tracking + coaching offerings, along with low-cost monthly supplies. It is of course possible that through online outreach, a high number of their existing users participated in the survey. Still, good for them!

 

30 Apps Selected for 2019 Review

So what drove people to choose the apps they did… among the motivational choices of Features/ Functions, Ease/ Usability, Recommended, Linked/ Integrated/ Compatibility and Other…?

Interestingly, Food Tracking was the only app category where “Features and Functions” was ranked highest as the driving force in app choice, versus “Linked/ Integrated/ Compatibility” for everything else. Clearly when it comes to any tool for BG data, interoperability is key!

Based on all these results, AADE has selected an additional 30 apps to review and include in its DANA technology portal for 2019. Here is the list, with some important qualifying notes at the bottom:

 

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