Smartphone app helps control blood sugar in people at risk of T2D

Use of a smartphone application (app) and an intermittently scanned continuous glucose monitoring (isCGM) results in better glycaemic control, lower carbohydrate intake, and weight loss in people at increased risk of type 2 diabetes (T2D), reports a study.

“A lifestyle intervention using isCGM and a smartphone app improved glycaemic fluctuations and increased weight loss in people at high risk of T2D,” said lead author Masaru Kitazawa, Department of Hematology, Endocrinology, and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan.

Kitazawa and colleagues conducted a 12-week unblinded trial and recruited people with a haemoglobin A1c level of 5.6 percent to 6.4 percent or a fasting blood glucose of 110‒125 mg/dL and body mass index (BMI) >23 kg/m² but <40 kg/m². A total of 168 participants (mean age 48.1 years, mean BMI 26.6 kg/m², and 80.4 percent male) were randomized to the intervention (app; n=82) or the control group (n=86).

The difference in time in range of blood glucose between 70 and 140 mg/dL (3.9‒7.8 mmol/L) before and after the study duration between the two groups served as the primary endpoint.

At week 12, the app group demonstrated significantly better time in range of blood glucose at 70‒140 mg/dL than the control group (‒2.6 vs 31.5 min/d; p=0.03). No change was observed in time above range between the two groups, but time below range (blood glucose <70 mg/dL; 23.5 vs ‒8.9 min/d; p=0.02) significantly improved in the app group. [J Clin Endoc Metab 2024;109:1060-1070]

In addition, the app group showed a greater reduction in BMI compared with the control group (‒0.26 vs ‒0.59; p=0.017).

Diabetes prevention

Interventions with input from a medical provider are classified as follows: conventional T2D prevention programs conducted via a smartphone app and lifestyle coaching using features of the app. [JMIR Mhealth Uhealth 2020;8:e17842; JMIR Mhealth Uhealth 2020;8:e17842; JMIR Diabetes 2020;5:e21551]

“Although both have been reported to be effective in people at high risk for type 2 diabetes, involvement of healthcare providers remains in any case,” Kitazawa said. “There are few reports on the effectiveness of a smartphone app alone without involving healthcare providers in improving glycaemic variability and weight reduction in people at high risk for T2D.”

The current program is highly personalized in lieu of a medical provider’s intervention and combines two types of messages: regularly delivered T2D prevention guidance and messages personalized by an algorithm based on dietary, physical activity, and blood glucose monitoring records.

“As a result, blood glucose fluctuations, body weight, and carbohydrate intake were improved, which revealed the effectiveness of the smartphone app in combination with appropriately personalized and automated interventions, such as the isCGM, in those at high risk of T2D,” Kitazawa said.

“Further trials are needed to confirm whether these interventions can reduce incident T2D in the future,” he said.