Efficacy Of Mobile Apps In Controlling Diabetes In Patients: A Review

Overview of mySugr App

mySugr App is a smartphone App which aims to provide all-around care for the people with diabetes. It is startup founded in 2012 in Vienna, Austria. Currently, it has offices in Vienna, Austria and San Diego area. It is one of the most successful mobile App developed for diabetes and has a growing customer base.  It provides a wide range of offerings in its digital diabetes portfolio such as therapy management, data tracking and integration with other medical devices.  It is available in fifty one countries and thirteen languages.

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The company is founded by the people with knowledge and experience of diabetes and uses high product quality to technology to assist people with diabetes. It is a registered class 1 medical device in the US and EU and the company is ISO 13485 certified. With this App, the users can get advice from the certified diabetes educators. The solutions provided by the people are practical and helpful as most of the coaches are patients of diabetes themselves. With mySugr, the users do not need to worry about managing the information regarding diabetes. All the information is managed and accessible though the mobile app. It has about 940,000 users who are diabetic patients. This App is beneficial during the times which a diabetic person cannot access the doctor. He does not require making tricky decisions to get the sugar right on track. With the Mobile App, the user can get the expert advice from the people with handling diabetes themselves. It is a beneficial App and has reduced the blood glucose level of its users in a systematic manner. It tracks the blood glucose by using the blood glucose readings and considering the impact of frequency and severity of the blood glucose events on the people living with diabetes. The high risk population can also use mySugr App to prevent becoming diabetic patient.  With this App, the users can log their metabolic control data and other events which can impact their blood sugar level in the app and find useful advice to prevent o control diabetes.

The mySugar Coaching feature of the mobile App was introduced in 2016 and focuses on improving the consumer experience from the insulin therapy to the management of the blood sugar level.

Diabetes is a disease which requires constant assistance and attention from the doctor; however, the patients are only able to discuss their condition with the doctors every three months. A large number of people feels helpless between the long periods of the medical appointments and require quick support from the medical authorities. With the mySugr Application coaching feature, the customers can easily access the knowledge regarding diabetes with just a touch of button. It provides the customers with proactive therapy wherein the customers get solutions as per their requirements. The users can define various long-term goals such as weight loss or decreasing the blood sugar level and use the expert advice of the medical professionals to achieve goals. Another program mySugar Academy, an online program is developed by doctors, dieticians, nurses and other people with diabetes. This program is aimed to answer the concerns and the apprehensions of the people with the type 2 diabetes.

Impact of mySugr App

With the turn of the 21st century, a large number of mobile applications have emerged to assist the population in management of the diabetes. It is the seventh leading cause of death and results in other cardiovascular conditions such as vision problems, kidney conditions and cardio issues. The management of diabetes requires adherence to the treatment recommendations provided to the patients. It also requires the patient to regularly perform check-ups regarding the blood sugar, maintaining healthy diet, exercise and regular visit to the doctors (El-Gayar et al., 2013).

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Norris et al. (2002) has discussed that a large number of patients find it difficult to adhere to these requirements which results in poor quality of life and increase in mortality and morbidity rate. With the technical advancements, numerous innovative ideas have emerged to increase the self-management of diabetes and assist in effective healthcare.  The Mobile application based healthcare is a component of the eHealth which assists in the support the self-management of the public health practice with the mobile devices. The mobile applications can be used for increasing the access to the health information of the patients, facilitate the remote patient monitoring and delivering effective recommendations and providing  reminders to the patients. The use of mobile app in the self-management is an emerging technology which is transforming the health care. In this essence, this paper will discuss the efficacy of the mobile-based applications in controlling diabetes in the patients.

In the views of Whitehead and Seaton (2016), the number of people with chronic diseases is increasing worldwide and the medical advances have increased the life expectancy of the people; however, without effective self-management the quality of life of the people with chronic disease is degrading. There are several challenges in the collaboration of the individual and the healthcare providers to provide effective healthcare. In the management of the long-term conditions, it is important that the healthcare providers have access to information, assessment and the treatment of all the vitals of the patient.  The integration of the mobile apps in the healthcare can reduce the traditional barriers in the effective healthcare and minimize the barriers of the distance, cost and the time. According to the literature, the mobile applications allow the physicians to prescribe a course of action by monitoring the adverse events and identifying the areas of improvement (Whithead and Seaton, 2016).  

According to Brzan et al. (2016), the use of mobile apps can prove to be highly beneficial in managing different aspects of the people’s life. Likewise, the use of the mobile application can prove to be very useful in the management of the chronic diseases. Today, there are numerous applications available in the market which can help the people with the diabetes in controlling their fitness and health. According to the literature, the self-management of diabetes encompasses monitoring of blood glucose level and medication, providing nutritive diet, suggesting physical exercise and controlling body weight.

Mobile-based Applications in Managing Diabetes

According to Shah and Garg (2015), the number of diabetic patients is constantly on a rise. The poor management of the disease can result in several health-related complications as well as increase in the healthcare expenditure. The literature has cited that poor glucose control can result in long-term diabetes, vascular complications which can increase the morbidity and the mortality rate of patients. With the lack of self-management, the total medical expenditure of the customers also increases; therefore, the self-management of diabetes is important. The literature cites that with the increase in the broadband and the mobile app market, the government and the medical professionals can develop implementation techniques to empower the patients and improve the overall efficacy of the healthcare. It is especially important with the inadequate number of specialists and lack of resources in the developing countries. With the development of the cost-effective tools in the diabetes-management the level of healthcare can be uplifted to a high extent.

Holtz and Lauckner, (2012) has discussed that the diabetic patients who uses self-monitoring techniques have better control over their disease. The mobile applications are effective in managing diabetes as they offer a variety of communication methods and are relatively inexpensive. Moreover, a large number of populations owns or have access to the mobile phones which establishes ubiquitous nature of the smartphones. Therefore, the healthcare providers and the researchers can use mobile phones to educate people and assist them in the management of their health issues. The literature discusses that the interaction of the patients with the healthcare provider are limited which can be due to the hesitation of the healthcare provider in the adoption of technology, questions regarding reimbursement, liability and privacy. This issue is especially significant as the healthcare providers play a significant factor in the adoption of the technology. Another significant barrier in the adoption of the self-management apps is that they were developed in different technologies and it might be possible that these mobile apps cannot run on the personal mobile phones of the users. Furthermore, the users can also find carrying two mobile phones challenging. Carrying an unfamiliar phone can result in different patterns of usage which can impact the efficacy of the mobile phone users.

According to Demidowich et al. (2012) another challenge in the effective use of mobile phone applications for blood sugar level monitoring is the engagement of the users with the mobile application. The literature cites that there are only a few highly active users who send the majority of the messages through these apps. Although with the prevalence of the mobile phones, a large number of mobile applications have been developed which supports the chronic diseases like diabetes; however, the users are concerned about the quality of the healthcare and advices provided through these applications.

Challenges in the Adoption of Self-Management Apps

Carter et al. (2016) has discussed that the mobile based applications can prove highly effective in the self-management of the diabetic patients. It is due to the low cost and omnipresent nature of the mobile phones. It can be used for healthcare promotion in an interactive and dynamic manner. The mobile apps can be used to standardize the self-management of the type 2 diabetes. The functionality and the use of these applications should be standardized to increase their efficacy. The government should also develop policy and guidance to improve the self-management health care in the patients.

Rstau, Yang and White (2013) have stated that diabetes is huge economic burden on the US Healthcare system with the average estimate of 174 billion US dollars. The literature has cited that proper healthcare is important because diabetes is a progressive disease which leads to various complications like heart diseases, strokes, neuropathy and hypertension. A number of mobile apps have emerged which can assist the technology-savvy customers in the diabetes management.  It is important that the business healthcare professionals enhance the management of the disease by the promotion of the mobile app. Before recommending the mobile apps to the users, the healthcare professionals must examine the age, app cost and the app specific features for increasing the efficacy of the mobile apps. The literature has recognized the major challenges in the implementation of the mobile application in the diabetes self-management. One of the primary concerns in the adoption of the mobile apps is the patient’s demographics. The young population is highly proficient in the use of mobile applications; however, the majority of the diabetes patients are above the age of 55 who did not grow up immersed in the technology and find it difficult to operate mobile applications. Therefore, simple to use mobile application should be developed so that these customers can use these applications.

According to De Jongh, (2012) another significant barrier is the cost of these applications. The customers have to buy a smartphone for getting access to these mobile apps which can prove a significant barrier in the adoption of the mobile app.

In the same essence, Norris et al. (2002) have discussed that the mobile applications can prove effective in glycemic control in type 2 diabetes patients. The study states that Glycemic control is crucial for examining the efficacy of the complication of diabetes. The literature elaborates that long-term intervention can be achieved in the glycemic control by the intervention of the mobile applications. The contact time is a crucial indicator in the control of glycemic control and; however, short-term intervention proves to be ineffective in it is control. Therefore, the mobile applications are crucial in the diabetes control.  Certain variations might occur in the outcomes of these applications due to psychosocial mediators, intervention characteristics such as culture relevancy and contextual factors such as linkage to primary care system.

Engagement of Users with Mobile Applications

Chomutare et al. (2011) have discussed that there is strong gap between the evidence-based recommendations in the mobile apps and proper functionality. The study elaborates that without proper standardization of the mobile apps, the self-efficacy, self-care activities and the quality of life cannot be enhanced.

Arsand et al. (2010) have stated that there has been an exponential rise in the lifestyle related diseases in the present population. The healthcare researchers and the organizations have developed several tailor-made information and technology tools which can positively influence the self-care of the users. The literature examines that several issues such as screen design, input device and the interface style impacts on the use of the mobile applications especially on the older generations. In order to combat these challenges, the healthcare organizations should teach the users how to take advantage of available technologies.

According to El-Gayar, (2013) the design of the mobile applications should be developed with thee focus on the human-mobile interaction. The design processes which remain unsuccessful in involving the end users in the design loops cannot analyze the demands and the requirements of the users and cannot involve the real users in the design and testing of the developed prototypes.

Kaplan, W.A. (2006) has discussed that in the development of these mobile applications, the users should focus on the actual user for them to be successful. Accordingly, the literature has highlighted that the mobile applications should be developed with major focus on the functionality of the applications. The mobile apps should be as authentic as possible and should require minimum efforts from the users. All the features of the mobile application should also be interconnected with each other such as healthy diet, blood glucose level and the physical activity. The automatic monitoring of these activities can be attained by establishing a tailor-made counter with Bluetooth, glucose monitor and tailor-made step counter.

It could be summarized that mobile application plays a crucial role in the self-management of diabetes and other chronic diseases. Diabetes is a chronic disease and requires long-term commitment and self-management by the patient. If it is not managed properly, it can adversely impact on cardio-vascular health of the patients. The mobile applications offer constant monitoring of the vital characteristics of the users at a very cheap cost. There ubiquitous nature and easy accessibility will assist the healthcare professionals in monitoring the patients located at remote locations. There are certain barriers in the use of the mobile applications in diabetes monitoring. It includes the standardization of the procedure and the acceptability of the healthcare professionals towards it. There are also concerns regarding the remuneration and the privacy of the healthcare professionals. Moreover, the applicability of these apps can be increased by standardizing the procedure, increasing the government intervention and developing applications which are easy to use and requires minimum manual efforts. The cost associated with the running these applications, is also high. First, the user has to buy a smartphone which is high initial investment. Sometimes, these applications do not run on the standard smartphone and requires different phone which increases the cost and the discomfort level of the users. In the present scenario, it is important that the researchers develop the mobile applications which best suit the users.

References:

Arsand et al. (2010). Mobile Phone-Based Self-Management Tools for Type 2 Diabetes: The Few Touch Application. Journal of Diabetes Science and Technology 4(2), 328-337.

Brzan, P.P., Rotman, E., Pajnkihar, M. and Klanjsek, P. 2016. Mobile Applications for Control and Self-Management of Diabetes: A Systematic Review. J Med Syst 40(9), pp. 210.

Carter, B., Hou, C., Hewitt, J., Francisca, T. and Mayor, S. 2016. Do mobile phone applications improve glycemic control in the self-management of diabetes: A systematic review, meta-analysis and GRADE of 14 RCTs. The World Congress on Clinical Trials in Diabetes 43.

De Jongh, T., Gurol?Urganci, I., Vodopivec?Jamsek, V., Car, J. and Atun, R., 2012. Mobile phone messaging for facilitating self?management of long?term illnesses. The Cochrane Library.

Demidowich, A.P., Lu, K., Tamler, R. and Bloomgarden, Z., 2012. An evaluation of diabetes self-management applications for Android smartphones. Journal of telemedicine and telecare, 18(4), pp.235-238.

El-Gayar, O., Timsina, P., Nawar, N. and Eid, W., 2013. Mobile applications for diabetes self-management: status and potential. Journal of diabetes science and technology, 7(1), pp.247-262.

Holtz, B. and Lauckner, C. 2012. Diabetes Management via Mobile Phones: A Systematic Review. TELEMEDICINE and e-HEALTH 18(3), 175-184.

Hood, M.M. et al. (2016). What do we know about mobile applications for diabetes self-management? A review of reviews. Journal of Behavioral Medicine, 39(6).

Kaplan, W.A. (2006). Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Globalization and Health 2(9).

Kirwan, M. et al. (2013). Diabetes Self-Management Smartphone Application for Adults With Type 1 Diabetes: Randomized Controlled Trial. J Med Internet Res 15(11).

Norris, S.L. et al. 2002. Self-Management Education for Adults With Type 2 Diabetes. Diabetes Care 25(7), 1159-1171.

Risatu, R.A., Yang, J.B.S., White, J.R. 2013. Evaluation and Evolution of Diabetes Mobile Applications: Key Factors for Health Care Professionals Seeking to Guide Patients. Pharma Diabetes Spectrum 26(4), 211-215.

Shah, V.N. and Garg, S.K. 2015. Managing diabetes in the digital age. Clinical Diabetes and Endocrinology 1(6).

Whitehed, L. and Seaton, P. (2016). The Effectiveness of Self-Management Mobile Phone and Tablet Apps in Long-term Condition Management: A Systematic Review. Journal of Medical Internet Research 18(5).

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