A Mobile App for Synchronizing Glucometer Data: Impact on Adherence and Glycemic Control Among Youths With Type 1 Diabetes in Routine Care

Many individuals with type 1 diabetes (T1D) upload and review blood glucose data between clinic visits. Mobile phone applications that receive data from a "connected" glucometer and that support pattern management are available and have the capacity to make data upload and review less burdensome. Whether mobile apps can improve diabetes self-management among individuals with type 1 diabetes remains unknown.We analyzed retrospective data on 81 youths with T1D who were trained to use a glucometer-connected mobile app in their self-management. To assess the effect of glucometer synchronization ("sync") rate on hemoglobin A1c (HbA1c), mean blood glucose (mBG), and daily frequency of SMBG, we regressed those clinical outcomes on the frequency of glucometer syncs with the mobile app after controlling for other clinical care variables.Median age was 14.0 (IQR 10.4-15.9) years, median duration of diabetes was 4.9 (2.7, 7.5) years, and median baseline HbA1c was 8.6% (7.9, 9.8). The sample was 49% male and 86% white. Youths with T1D synchronized glucometer data with the mobile app an average of 0.22 times per week (range 0-2.25). The glucometer sync rate did not have a statistically significant association with HbA1c or mean BG; in contrast, data sync frequency was associated with the frequency of self-monitoring of blood glucose (SMBG) such that each additional sync was associated with a 2.3-fold increase in SMBG frequency ( P.01).A glucometer-connected mobile app may increase an individual's engagement with other aspects of care (eg, SMBG frequency). Whether diabetes device-connected mobile apps can improve glycemic control remains to be determined.