User Demographics and Real-World Engagement with the Digital Diabetes Companion App Dibi: A Retrospective Analysis (Preprint)

BACKGROUND Type 2 Diabetes (T2D) is a chronic condition requiring lifelong personalized management to prevent disease progression and complications. Mobile health applications like dibi can substantially support patients in daily disease management. OBJECTIVE This study analyzes user demographics through real-time longitudinal data to improve user engagement, advance personalized care and facilitate predictive healthcare strategies. METHODS Of 5744 dibi users, 2422 (42.2%) provided consent and completed registration (date: 15.12.24). A total of 2262 users with active consent and age ≥ 18 years were included in the analysis and analyzed based on self-reported diagnosis, age, gender, treatment and diagnosis year. Among those, 1253 (55.3%) users defined at least one medication plan with overall 1,039 unique medications. Further, 514 (41.0%) users utilized the adherence feature at least once to track medication intake. RESULTS In 2021, 89.3% of dibi users were patients with T2D, mostly male (57.4%), aged 56-65 years (33.5%) and recently diagnosed. Female T2D users were on average younger and more often chose lifestyle changes only during onboarding. Most T2D users (36.9%) reported either treatment with oral antidiabetics (OAD) only or lifestyle modifications alone (17.1%). Of the T2D patients who used medication plans, the majority (57.0%) reported using only OADs, while 7.2% reported only non-diabetes medications. More escalated treatment regimens were observed with longer disease duration. While 87.5% confirmed medication intake at least once, 29.6% used the adherence feature only once. CONCLUSIONS This analysis demonstrates that the dibi app is widely accepted and used by patients with T2D in Germany. It provides insights into treatment patterns and patient reported lifestyle changes. The dibi cohort reflects trends seen in other studies, representing real-world disease management. These findings indicate that inclusion of medical questionnaires, and clinical metrics, such as HbA1c, will deepen our understanding of the disease and enable treatment-lifestyle correlations.