The majority of diabetes ‘decision support’ apps currently on the market do not give real-time warnings or advice on blood glucose self-management, a major review has found.

The findings have prompted the authors to call for diabetes apps to be certified to a certain standard before they are marketed to individuals with diabetes.

The analysis of 371 apps available through android and iOS found that while blood glucose levels could be recorded in all of the apps, only about one-fifth had explicit alert messages for hypoglycaemia.

And only 15% of the apps prompted the user on hyperglycaemic events while just over a quarter of the apps gave reminders to measure blood glucose and HbA1c.

“Of concern, in most apps, consecutive low or high blood glucose values did not trigger an escalation of alerts that could prevent severe hypoglycaemia or hyperglycaemia,” wrote the authors in a letter published in JAMA.

The reviewers said almost one in ten people with diabetes who own a smartphone report using an app for self management, but apps are not subject to regulation by bodies such as the FDA and thus there is no verification of their functions, effects and clinical safety.

They said their findings illustrated the immaturity of diabetes apps, together with a lost opportunity to improve the care of people with diabetes.

“Quality assurance mechanisms such as certification of apps are needed to help achieve their potential of supporting diabetes care,” they concluded.