Abstract
BACKGROUND: Diabetes self-management (DSM) applications (apps) have been designed to improve knowledge of diabetes and self-management behaviors. However, few studies have systematically examined if diabetes apps followed the American Association of Diabetes Educators (AADE) Self-Care Behaviors(™) guidelines. The purpose of this study was to compare the features of current DSM apps to the AADE7™ guidelines. METHODS: In two major app stores (iTunes and Google Play), we used three search terms "diabetes," "blood sugar," and "glucose" to capture a wide range of diabetes apps. Apps were excluded based on five exclusion criteria. A multidisciplinary team analyzed and classified the features of each app based on the AADE7(™). We conducted interviews with six diabetes physicians and educators for their opinions on the distribution of the features of DSM apps. RESULTS: Out of 1050 apps retrieved, 173 apps were identified as eligible during November 2015 and 137 apps during December 2017. We found an unbalanced DSM app development trend based on AADE7(™) guidelines. Many apps were designed to support the behaviors of Healthy Eating (77%), Monitoring (76%), Taking Medication (58%), and Being Active (45%). On the other hand, few apps explored the behaviors of Problem Solving (31%), Healthy Coping (10%), and Reducing Risks (5%). From interviews, we identified the main reasons why only a few apps support the features related to Problem Solving, Healthy Coping, and Reducing Risks. CONCLUSIONS: Future diabetes apps should attempt to incorporate features under evidence-based guidelines such as AADE7(™) to better support the self-management behavior changes of people with diabetes.