The Promise and Peril of Mobile Health Applications for Diabetes and Endocrinology

We are in the midst of what some have called a mobile health revolution. Medical applications (apps) for mobile phones are proliferating in the marketplace and clinicians are likely encountering patients with questions about the medical value of these apps. We conducted a review of medical apps focused on endocrine disease. We found a higher percentage of relevant apps in our searches of the iPhone app store compared with the Android marketplace. For our diabetes search in the iPhone store, the majority of apps (33%) focused on health tracking (blood sugars, insulin doses, carbohydrates), requiring manual entry of health data. Only two apps directly inputted blood sugars from glucometers attached to the mobile phone. The remainder of diabetes apps were teaching/training apps (22%), food reference databases (8%), social blogs/forums (5%), and physician directed apps (8%). We found a number of insulin dose calculator apps which technically meet criteria for being a medically regulated mobile application, but did not find evidence for FDA-approval despite their availability to consumers. Far fewer apps were focused on other endocrine disease and included medical reference for the field of endocrinology, access to endocrine journals, height predictors, medication trackers, and fertility apps. Although mobile health apps have great potential for improving chronic disease care, they face a number of challenges including lack of evidence of clinical effectiveness, lack of integration with the health care delivery system, the need for formal evaluation and review and organized searching for health apps, and potential threats to safety and privacy.