The one drop diabetes iOS and WatchOS app with in-app coaching from certified diabetes educators improves blood glucose, carbohydrate intake, and physical activity
Over 1,500 mobile apps assist in the management of diabetes. Meta-analyses suggest diabetes apps improve A1c by -.49%. To our knowledge, no study has evaluated a diabetes app with passive data tracking on a smartphone and smartwatch with in-app support from a Certified Diabetes Educator (CDE). Over 250,000 people with diabetes and pre-diabetes worldwide use the One Drop | Mobile app. Users track blood glucose and self-care behaviors manually and via Apple HealthKit’s connection to other apps, meters, continuous glucose monitors, activity trackers, get recipes, insights, and tips and receive and give community support (‘likes’, stickers, data sharing). One Drop | Experts are CDEs delivering ‘on call’ in-app support and the first digitally-delivered diabetes education program accredited by the American Diabetes Association. Beginning in October 2016, Evidation Health, Inc. recruited 144 English-speaking U.S. adults with T2D to complete a survey, receive an Apple Watch, and use the One Drop iOS/watchOS app for an IRB approved study. We tested de-identified blood glucose and self-care data tracked in the app during that 3-month evaluation. Pooled repeated measures models assessed within changes in blood glucose and self-care over time, differences by high vs. low tracking, and the interaction of time by high vs. low tracking. Participants were, on average, 52 ± 10 years old, 72% female, 17% Hispanic, 10% Black, 11%=high school educated, 51% on insulin, and diagnosed with diabetes for 11±7 years. Blood glucose and self-care significantly improved over time. Participants’ average blood glucose went from 203 mg/dL to 168 mg/dL (or A1c 8.7% to 7.5%, -1.2%), p<.001. Glycemic variability went from SD 43.9 mg/dL to SD 32.5 mg/dL, p<.001. The percentage of high blood glucose readings went from 49% to 39%, p=.006. The percentage of in-range blood glucose readings went from 50% to 59%, p=.008. Carbohydrate intake went from 53 to 33 grams per meal, p<.001. Physical activity measured both manually (121 min at baseline to 156 min at 2 months) and passively via HealthKit increased over time (295 min baseline to over 520 min), p<.001. The ‘One Drop app + Experts’ significantly improved blood glucose, carbohydrate intake, and physical activity over 3 months. Findings support the health benefit of a diabetes app with passive data tracking, in-app coaching, and a global reach.