Apps can help keep blood sugar in balance

As anyone with diabetes knows, the daily grind of managing the disease - from watching carbs and calories to tracking blood sugar and A1C levels - can be tiresome. In an age when there's an app for just about everything, it seems as if this is a problem just waiting to be solved by technology. This should be easy, right?

When I searched my iPhone's app store for "diabetes," however, I was stopped cold: More than 1,200 apps came up, not to mention related links to others. This may be a great use of technology, but deciding which apps are best? Not easy for a layperson.

"It's encouraging to see so many apps that attempt to ease the self-care tasks and tracking associated with all types of diabetes," Kelly Rawlings, editorial director of Diabetes Forecast magazine, told me. "But the sheer number and range of usability make it a tricky product area to navigate for health care providers and the people who use the apps."

Rawlings is right - and things are likely to get even more complicated. According to the most recent National Diabetes Statistics Report from the Centers for Disease Control and Prevention, 29 million Americans have diabetes, and 95 percent of them have Type 2, the form most associated with obesity. To boot, new cases of diagnosed diabetes among people age 20 or older topped 1.7 million; the report also estimates that 86 million Americans older than 20 suffer from pre-diabetes, most of whom are at a high risk of developing Type 2 diabetes.

Those numbers provide a lot of incentive for app makers to develop new products, and there is scientific support as well. A study published in the journal Clinical Diabetes concludes that "the use of mobile phones leads to improved A1C and self-management in diabetes care." But with the app store already crowded with possible solutions and with more of them likely to come in the future, how can people figure out which app is right for them?

As endocrinologist David Marrero, the director of Indiana University's Diabetes Translational Research Center, put it: "Depending on the situation and the individual, apps can be very worthwhile, especially for [the] support" they can provide from others. He added bluntly: "Some are junk. Others are very well designed. Most of them, in my experience, are very complicated." And for people with diabetes, choosing among them can depend on one's needs and level of tech-savviness.

Ron Gerard, 60, a former programmer who has Type 2 diabetes, echoes Marrero's perspective. Even for someone with a tech background, Gerard said, "some apps were too complicated, while others wanted too much information," creating privacy issues. Through trial and error he has found a handful of apps that meet his needs, including Dbees, which tracks his blood sugar and turns the numbers into a graph he can print out for his endocrinologist.

Teresa Van Blade, 44, who was diagnosed with Type 2 diabetes four years ago, likes Diabetes Tracker, which she uses on her Kindle. "It's a neat little app that helps me keep track of my blood glucose," she said. "It also reminds me of doctor's appointments and gives me recipes and food guidelines." She admits she had to play around with several apps before deciding which one was best for her. Her advice: "Just look around. It's ... a personal preference as to what you want in the app."

Marrero recommends choosing apps based on individual goals. For some people with diabetes, that's weight control; others need help tracking blood glucose or remembering to take medication, while some turn to their apps to find community support. Most people I spoke with agreed there's no one app that does all of that well - yet.

For Bennet Dunlap, 57, diagnosed five years ago, exercise is a key strategy in keeping his condition under control. He tried Strava, an all-purpose cycling and running app, after hearing about it from another person with diabetes. Since downloading the app, which features numerous group challenges (such as 10Ks and half-marathons), Dunlap has been able "to connect to other people with diabetes who stay active." He says he has lost 20 pounds since last summer.

For Naveed Moeed, 41, the primary goal is tracking his glucose levels, for which he uses mySugr. He enters his blood sugar levels and food intake into the app, which uploads his data to his iPhone. The phone's iHealth dashboard displays in graph form data collected from mySugr as well as workout and sleep data from other apps. "The individual apps can provide warnings and reminders," Moeed says, "but the real next step in this evolution for me is for my primary care provider to get all of the data on my dashboard to help inform my dietary and health decisions and provide oversight and encouragement."

Moeed, who is an IT professional, calls 2015 "the year of convenience for Type 2 diabetes."

Apps may be the smartest way to manage diabetes for many people, but as Diabetes Forecast's Rawlings says, "unused apps stored on a smartphone do not change behavior or improve health."

In the perfect app, data entry would be automatic and would integrate seamlessly with medical devices. Until then, as Moeed says, humans are the weak link: "If I don't have the discipline to take my blood sugar and input my food, then everything else is useless. If you take ownership of your health care, then technology really helps."

Based on the recommendations of diabetes experts and people with diabetes as well as on my test drives for ease of use, here are some of the best apps, grouped by goal. (Comments refer to the free version unless otherwise stated.)

For Weight Management

• Lose It! (weight-loss program and calorie counter)

Free; year of premium features $39.99

iPhone (offers Apple Watch app, too) and Android

One of Marrero's top picks: "A very nice app for managing your weight. It helps you track what you eat, will help you set goals and has a very robust database that helps you calculate the composition of the food you eat." The new version for the Apple Watch literally nudges users to stay on track with its notification feature.

• Weight Watchers (Weight Watchers International)

Free to download; 12-month plan $169.99

iPhone and Android

This easy-to-use app features 24/7 expert chat, which allows users to get motivation and advice from a certified coach. iOS 8 users can connect to Apple's iHealth to link all health and fitness data - a big plus.

Blood Glucose Trackers

• Glucose Buddy (diabetes logbook manager)

Free; premium version is $6.99

iPhone and Android

Simple to navigate, Glucose Buddy helps users manage their blood sugar, insulin dosages and carb intake. Other features track exercise, blood pressure and weight. Sync data to print it out or view online.

• Diabetes Tracker

$9.99

iPhone

The American Journal of Preventive Medicine ranked this app, which has no free version, No. 1. It boasts an intensive and easy-to-follow educational component in addition to features for monitoring blood glucose, carbs, net carbs and more. Easy to see the big picture with daily and weekly reports. For some, it may be worth the extra expense.