Variability of endocrine findings with age and clinical severity in the long-term follow-up of pseudohypoparathyroidism: evidence of TRH resistance with central hypothyroidism.

Type 2 Diabetes (T2D) is a highly prevalent, chronic metabolic disease, in which chronic energy imbalance, favor of nutrient-storage pathways, and other pathomechanisms contribute to insulin resistance, impaired insulin secretion, and subsequent hyperglycemia (). The condition requires personalized and continuous management to prevent complications such as cardiovascular disease, neuropathy, and kidney failure (). Reducing hyperglycemia is first and foremost attempted by adjusting lifestyle factors of affected patients. If this is not sufficient, numerous different antidiabetic drugs are available to reduce glycemic parameters, as well as the risk to suffer from cardiovascular complications. As the last treatment step, patients are recommended to use insulin injection therapy to adequately manage their glucose metabolism (). The daily management of T2D includes monitoring the nutritional intake, regular exercise and medication adherence, as well as routine glucose measurements and appointments with healthcare practitioners. The disease itself and its management significantly impair the quality of life of patients (). Mobile health applications have revolutionized diabetes management by offering patients real-time tracking of blood glucose levels, medication adherence, dietary patterns, and physical activity (). These apps also provide feedback, reminders, and access to educational resources, empowering patients to self-manage their chronic condition and enhance their medication adherence as well as their glycemic control (, ). Companion apps, in particular, create an interactive ecosystem between patients and healthcare providers, facilitating personalized care. The wealth of data generated by these apps, including demographic information, opens new opportunities for research and public health insights. Crucially, such tools can only deliver clinical benefit if patients actually adopt them and continue to use them, yet real-world adoption and engagement are highly variable and remain poorly characterised for newly launched apps. Understanding who uses a given app, and how intensively, is therefore a prerequisite both for designing effective, tailored strategies to support sustained app use and for interpreting any downstream clinical signal.