Real-World Effectiveness of Glucose-Guided Eating Using the Data-Driven Fasting App Among Adults Interested in Weight and Glucose Management: Observational Study
Background: The Data-Driven Fasting (DDF) app implements glucose-guided eating (GGE), an innovative dietary intervention that encourages individuals to eat when their glucose level, measured via glucometer or continuous glucose monitor, falls below a personalised threshold to improve metabolic health. Clinical trials using GGE, facilitated by paper logging of glucose and hunger symptoms, have shown promising results. Objective: To describe user demographics, app engagement, adherence to glucose monitoring, and the resulting impact on weight and glucose levels. Methods: Data from 6,197 users who logged at least two days of preprandial glucose readings were analysed over their first 30 days of app use. App engagement and changes in body weight and fasting glucose levels by baseline weight and diabetes status were examined. Users rated their preprandial hunger on a 5-point scale. Results: Participants used the app for a median of 19 days (25th, 75th percentiles: 9, 28 days), with a median of 7 weight entries (25th, 75th percentiles: 3, 13 entries) and 52 glucose entries (25th, 75th percentiles: 25, 82 entries). On days when the app was used, it was used a median of 1.8 (25th, 75th percentiles: 1.4, 2.1) times. A significant inverse association was observed between perceived hunger and preprandial glucose concentrations, with hunger decreasing by 0.22 units for every 1 mmol/L increase in glucose (95% CI: -0.23, -0.21, p
