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Continuous Glucose Monitoring for Personalized Nutrition in Real-World Vively App Users: Retrospective Observational
Michelle R Jospe1, Kelli M Richardson1, Susan M Schembre1
1Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, United States.
JMIR Human Factors
|April 29, 2026
Summary
Engagement with continuous glucose monitor (CGM) apps is high, but food logging declines sharply after CGM wear. Sustained engagement requires strategies beyond passive monitoring for digital health interventions.
Area of Science:
- Digital Health Interventions
- Metabolic Health Monitoring
- Behavioral Science in Health
Background:
- Continuous glucose monitors (CGMs) integrated with digital health apps are increasingly popular for personalized metabolic health management.
- Limited understanding exists regarding user engagement patterns and factors influencing sustained use of these CGM-integrated apps.
Purpose of the Study:
- To characterize user demographics, CGM usage, and food logging behaviors within the Vively digital health app.
- To identify factors associated with sustained engagement in continuous glucose monitoring (CGM) wear and food tracking.
Main Methods:
- Retrospective observational study of 7647 Vively app users (August 2021 - February 2025) integrating with Abbott FreeStyle Libre CGMs.
- Analysis of CGM wear duration and food logging frequency, utilizing negative binomial and hurdle negative binomial regression models.
- Adjusted for age, sex, BMI, baseline glucose, and device connectivity to identify engagement drivers.
Main Results:
- Users exhibited a median CGM wear of 15 days, with 30.3% completing two or more wear periods.
- Food logging was prevalent during CGM wear (median 47 entries over 12 days) but decreased significantly post-sensor removal.
- Connected device syncing strongly predicted both CGM wear and food logging; higher baseline glucose correlated with longer CGM wear but less food logging.
Conclusions:
- User engagement with CGM-integrated apps is largely tied to active CGM wear, with a notable drop in food logging during CGM-free periods.
- Divergent associations of baseline glucose suggest different motivations for passive monitoring versus active tracking.
- Future digital health interventions must develop strategies to maintain user engagement beyond biological feedback periods.
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