Can A Basic Management App Paired With A Glucose Meter Help Reduce Glucose Levels Among Adults With Type 2 Diabetes? The REALL Study

Abstract

Objective: Evaluations of technology to help adults manage type 2 diabetes (T2D) have yielded mixed results. We analyzed the effectiveness of a free app linked to a glucose meter to study reductions in glucose levels over time among a self-selected sample of adults with T2D. Research Design and Methods: Adults with T2D >12 months, >21 years, ability to read English (insulin using—IU and non-insulin using—NIU) who independently elected to pair their CONTOUR NEXT ONE meter with the CONTOUR DIABETES App were invited to participate. Glucose data from baseline to 16 weeks were uploaded to the cloud (N = 461). Assessment of diabetes distress, medication taking, quality of life, and hypoglycemia concerns occurred at baseline, six, and 16 weeks. Results: Findings indicated a significant decrease in weekly glucose levels over time: baseline mean = 169 (62.0) (9.4 mmol/L; 3.44); 16-week mean = 146.5 (36.0) (8.1 mmol/L; 2.0) ( P < .001), with no IU and NIU differences. Largest reductions occurred during the first six weeks, with no later rebound effects. Significant, though modest, improvements in global quality of life ( P = .03), hypoglycemia concerns ( P = .01), and diabetes distress ( P < .001) occurred over 16 weeks. Conclusions: Making an App for monitoring glucose easily available for download with a glucose meter can be helpful for self-selected adults with T2D. Effective utilization assumes that users are sufficiently motivated and engaged, are comfortable and trusting of the technology, and have sufficient knowledge of how to make use of the glucose data.