Diabetes Prevention App Users More Likely to Be Female, Obese vs General Population

This new study examined uptake and use of a digital tool meant to aid in diabetes prevention.

Patients who signed up to use a digital diabetes prevention tool tended to have higher rates of obesity than the general population, but women who used the app were less likely to have diabetes, according to a new demographic analysis.

The findings offer insights into which people are most likely to adopt digital prevention tools and highlight the real-world data-gathering capabilities of such tools. The study was published in Cardiovascular Endocrinology & Metabolism.

These data pertain to the application Waya, which launched in May 2020 and allows people who are overweight or at risk of diabetes to monitor and manage their weight, exercise, and lifestyle. The study was based on people (N = 837) who signed up to use the app by October 1, 2020, and who answered at least 1 health-related question. In order to better understand their particular users, the investigators compared the app’s users with the population included in the 2014-2015 German Health Update (GEDA) national survey.

The authors found that most people who signed up for the app were women (86.1%). In addition, the rate of obesity among app users was higher than in the GEDA population (39.4% of women and 37.1% of men in the Waya cohort vs 18% and 18.3%, respectively, in the GEDA cohort). Yet, the opposite was true for hypertension; just 12.1% of women and 22.4% of men using the Waya app had hypertension compared with 30.9% and 32.8% in the GEDA cohort.

Women using the app also were less likely to have diabetes than the GEDA population (3.9% vs 7%), although there was no difference in the diabetes rate among men in the 2 cohorts.

The authors said the finding that women were more likely to use the Waya app is in line with other research suggesting women are more proactive at using self-care or nutritional apps. Women also experience more social pressure to use such apps, they said.

“In the future, we plan on integrating more gamification features to also make the app more attractive for men to use,” they wrote.

The authors said it was expected that their app-user cohort would have higher rates of obesity than the general population, given that the app is targeted at people who have a higher risk of diabetes, and obesity has been linked with diabetes.

However, they also found that their users were less likely than the GEDA population to have another risk factor for diabetes: a history of smoking. They said the differences may be due in part to stepped-up efforts by German health authorities to curb rates of smoking in the country.

“[W]e believe that over time many have taken an informed decision to stop smoking (or not to start at all), explaining the rise in nonsmokers and the growing prevalence of former smokers,” they wrote.

The investigators said their study had the inherent limitation of being based on data that were self-reported by users. They added that the data were collected only at onboarding and therefore it was not possible to see how the app affected patient health. The investigators said they plan to continue studying the cohort, including the ways in which the app has an impact on its users’ quality of life, weight, and nutrition.


Balakrishnan P, Jacyshyn-Owen E, Eberl M, Friedrich B, Etter T. Real-world demographic patterns of users of a digital primary prevention service for diabetes. Cardiovasc Endocrinol Metab. 2022;12(1):e0275. doi:10.1097/XCE.0000000000000275

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