S.L.LIM1, M.TAY1, K.W.ONG1, J.JOHAL1, Q.V.YAP2, Y.H.CHAN2, G.YEO1, C.M.KHOO1, A.YAXLEY3
National University Hospital1, Yong Loo Lin School of Medicine2, Flinders University3
Mobile health apps are increasingly used to support diabetes self-management. We aimed to investigate the association between diabetes app engagement, and weight and HbA1c change in adults with Type 2 diabetes and prediabetes.
In this prospective study, 171 participants with Type 2 diabetes or prediabetes and body mass index ≥23.0 kg/m2 downloaded and used the Nutritionist Buddy Diabetes App. Body weight and HbA1c were measured at baseline and 6 months. App engagement data-points (476,300) were retrieved and analyzed using quartiles and monthly means and expressed as days per week. Generalized Mixed Model Analysis was used to determine the associations between app engagements and weight and HbA1c change. All results were interpretated in comparison to the respective reference groups.
The higher the app engagement (meal logging, keeping within carbohydrate and calorie limits, choosing healthier foods, self-blood glucose monitoring, weight charting, meeting steps count goal, communication with dietitian, watching educational videos and overall app utilization), the greater the % weight loss (p<0.05 for all the top quartiles). Usage of five or more app features ≥75% of the time across 6 months led to 6% more weight loss than lower app usage (p<0.001). The highest quartile of complete meal log had the greatest weight loss of 6.6% (p<0.001). Among participants with diabetes, all the highest app engagement quartiles were associated with clinically meaningful ≥0.5% HbA1c reduction (p<0.05 for all).
Higher app engagement, especially meal logging, led to greater weight loss and HbA1c reduction among adults with type 2 diabetes and prediabetes.