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(Reuters Health) – Hundreds of smartphone apps promise to make diabetes easier to manage, but very few offer real-time advice on what to do if blood sugar levels are excessively high or low, according to an American study.
The researchers examined 5,185 applications for phones using Google's Android software or Apple's iOS system. Of these, they found 371 applications that claimed to provide several key components for diabetes management: recording blood glucose data; remind patients when they need to do specific things to manage the disease; and educate patients on how to deal with conditions such as excessively low or high blood sugar levels.
"People with diabetes will have to make many decisions about not only their diet and lifestyle, but also the drugs to be taken and the dose based on their blood glucose," said Dr. Josip Car, lead author of the study, from the Center for Population Health Sciences of Nanyang Technological University in Singapore.
"Applications could potentially support some aspects of self-management – if they are well-designed," Car said via email. "But our study demonstrates immaturity of applications for diabetics and missed opportunities to improve care and health outcomes."
The study focused only on patients with type 2 diabetes, the most common form badociated with obesity and aging and occurring when the body can not properly use or produce enough insulin, a hormone , to turn blood sugar into energy. Untreated, diabetes can lead to nerve damage, amputations, blindness, heart disease and stroke.
About one in 13 people with diabetes who owns a smartphone uses an app to help manage their disease, noted researchers in JAMA.
Previous studies have suggested that using an application that supports blood glucose management could help people achieve blood glucose levels lower than they are able to manage themselves, wrote the study team.
Each application of the current badysis allowed people to record their blood sugar levels.
But only 37% let people set goals such as their blood glucose goal, and only 28% reminded patients to check their blood glucose.
Approximately 58% of applications alerted users when their blood glucose levels were dangerously high or low. However, only 21% of warnings about hypoglycemia offered solutions, and only 15% of warnings about hyperglycemia gave this type of advice.
When users were given tips on how to manage extremely low blood sugar, apps suggested eating food, fruit juice or sugar about 14% of the time – about as often as apps recommended to patients to consult a doctor.
With dangerously high blood sugar, apps that gave advice encouraged people to see a doctor about 13 percent of the time and offered insulin about three percent of the time.
The study can not prove if and how applications could have a direct impact on the health outcomes of people with diabetes. Another limitation is that applications have been revised in December 2018 and features may have changed since then.
"Smartphone apps can be a great way to track health data, but many inconsistencies, defects, and deficiencies need to be resolved," said Dr. Kevin Platt of the University of Michigan at Ann Arbor.
"The applications available vary enormously and the regulatory controls are minimal to ensure the accuracy and efficiency of the content," said Platt, who was not badociated with the study, by e-mail.
As the study shows, patients who depend on apps for medical advice may not get what they need when they need it, said Sheri Colberg of the Old Dominion University of Norfolk , in Virginia.
"Many of these apps had blood glucose alerts out of reach, but few helpful tips for tracking alerts," said Colberg, who was not involved in the study, by email.
"For example, the message" ask for medical help "is not helpful for most people who do not have easy access to medical care or the financial means to do it" , added Colberg. "It has been shown that self-management works better, but requires diabetes education not provided by most of these applications."
SOURCE: bit.ly/2VUrEQZ JAMA, online April 16, 2019.
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