This article is more than 5 years old. Information may no longer be current.
Diabetes educators provide tips for choosing useful health care apps
Click Here to Manage Email Alerts
A plethora of smartphone apps offer people living with diabetes assistance in many aspects of disease management, from self-monitoring to communication to dosing and insulin titration.
The options can be overwhelming, but diabetes educators can help users narrow them down to find apps that are appropriate based on individual medical needs, health literacy levels and familiarity with technology.
One of the most important functions of a diabetes management app is to “help people feel less overwhelmed,” according to Susan Weiner, MS, RDN, CDE, CDN, FAADE, an Endocrine Today Editorial Board member and diabetes educator in private practice.
“Apps are not for everybody,” Weiner said. People with diabetes who are not interested in these tools — whether due to health literacy issues, difficulty using technology or any other reason — should not be pushed to use them, she said.
But for those who do express interest, Weiner and Jennifer C. Smith, RD, LD, CDE, director of lifestyle and nutrition at Integrated Diabetes Services in Wynnewood, Pennsylvania, offer some tips for choosing among apps.
Simplify, don’t complicate
More than 1,000 apps for diabetes management are available, in addition to the more than 40,000 health management apps, so narrowing the options is key, according to Smith.
Smartphone users might want to try first the health data app that comes with their phone’s operating system — for most, either Apple Health or Google Fit, Smith said. Although many users disable them due to privacy concerns, these apps can help cut down on the clutter, she said.
“This link on the back helps these apps to ‘talk’ to each other,” Smith said. For example, an iPhone user can check Apple Health to get data from their continuous glucose monitor, glucose monitor and general food and exercise apps.
Additionally, using a smartphone’s preinstalled note-taking app to record feelings or mood throughout the day instead of downloading another app can be helpful.
Smith, who has diabetes, said she generally recommends limiting the number of diabetes management apps.
“For health tracking, the more features you can get in one app, the easier it is for someone to continue to use the app,” she said. “If they are tracking in multiple places, even if the apps ‘talk’ to each other, it becomes too much.”
Consider lifestyle
In addition to tracking data, Smith said some apps keep caregivers informed and can be used for both children and adults with diabetes.
Some device-specific apps feature a child-friendly user interface and can communicate information to caregivers or allow them to “follow” the data. Parents, a clinician or a school nurse can receive notifications when a glucose level is too low or too high, for example.
“The app connection there, from the caregiver standpoint, is huge because they can follow information no matter where they are [in relation to] their loved one,” Smith said.
Similarly, an adult with diabetes may want low blood glucose alerts to be sent to a spouse or other loved one as a backup safety measure.
Many diabetes management apps also connect data to a care provider for feedback.
One feature that Smith said a few apps, such as the RapidCalc Diabetes Manager and the PredictBGL Insulin Dose Calc, offer is the ability to determine insulin needs based on planned activity.
“From the standpoint of all of the stuff people think about on a daily basis living with diabetes, you have to consider, always, what have I done, and what is the impact going to be in the hours ahead based on what I plan to be doing? Those are constant thoughts in the head of somebody with diabetes, so from the standpoint of activity adjustment, if that is a piece that can be taken out of the picture, it would be helpful. Many people are curious about why that is not a piece of insulin pumps already,” she said.
Stay curious but cautious
Weiner and Smith both recommended use of the Diabetes Advanced Network Access (DANA) website, created by the American Association of Diabetes Educators. The resource allows members to compare apps for diabetes management as well as for general health management.
Smith noted while some preliminary research shows apps can help people with diabetes feel less stressed, there is no evidence of an improvement in clinical outcomes.
“We have to look at more research and more data to really show app users showing clinical improvement,” she said.
Evaluation should also take language into account. Just like health care providers, well-designed diabetes apps will use person-first language, Weiner said.
“It’s important to make sure the language of the apps is person-centered and nonjudgmental — encouraging users to continue to adopt positive changes around their individual goals,” Weiner said.
“From a provider and a clinician standpoint, I also advise that we stay very curious and not assume anything,” Weiner said. “We have to find out from the person what they are looking for, what their needs are, what their health literacy and numeracy are, if they are feeling overwhelmed, before recommending anything. Most health care providers know about apps that their organization is using and that’s all they’re familiar with. Take small steps, stay very curious and individualize. This is important with technology and with apps.” – by Amanda Alexander