User demographics and real-world use of the digital diabetes companion app dibi: a retrospective analysis.

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, self-reported treatment characteristics, and early feature use among users of the dibi digital diabetes companion app to better understand app uptake and feature use, advance personalized care and facilitate predictive healthcare strategies. Methods: Of 5,744 dibi users, 2,422 (42.2%) provided consent and completed registration (date: 15.12.24). Users were included if they had active consent and were aged ≥18 years, resulting in 2,262 users for the main analysis. Users with missing or invalid entries were excluded from respective parameter-specific analysis. Among all included users, 1,253 (55.3%) defined at least one medication plan with overall 1,039 unique medications, and 514 (22.7%) users utilized the adherence feature at least once to track medication intake. Results: Of the included users, 89.4% were patients with T2D, mostly male (57.5%), aged 56-65 years (33.5%) and recently diagnosed (0-1 year since self-reported diagnosis). Female T2D users appeared to be distributed toward younger age groups than male users 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. Conclusion: This analysis demonstrates that the dibi app reached a predominantly T2D user population 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.