Introduction: Diabetes self-management training (DSMT) is clinically effective but places a heavy burden on patients. Personalized coaching delivered via scalable mobile app platforms has the potential to provide much needed patient support.
Objectives: This study assessed feasibility and participant experience of a new mobile app-based platform for delivering DSMT to people with type 2 diabetes (T2D). The primary objective was to evaluate participant enrollment (recruitment into the study and completing first sign-in). Engagement with app features and health coach for the study duration was also evaluated.
Methods: Adults with T2D were enrolled into a 4-week prospective, single arm, observational study of the T2D App-based program. The T2D App provided medication reminders, meal logging, blood glucose (BG) tracking, and secure text messaging with a health coach. Participant engagement, satisfaction, participation in self-management behaviors, and finger stick BG results were also measured.
Results: Of 67 participants recruited 99% (66) were able to sign-in to the app and 64 of 67 (96%) completed the 4-week program. The majority of program participants used the T2D App daily (median 100% of days, mean 95% of days). Engagement rates in coach messaging and BG logging exceeded 95% of subjects and were sustained across the study duration. Average blood glucose (AG) in the study participants decreased from week 1 to week 4 (mean -7.8 mg/dL, sd 20.3, P=0.008). The subgroup of individuals with starting AG greater than 154 mg/dL (n=13) experienced the largest declines in AG (mean -29.6 mg/dL, sd 17.9, P<0.0001).
Conclusion: This initial feasibility study of a T2D App-based diabetes management program successfully enrolled participants and sustained their engagement. A decrease in AG was observed which, if sustained, would be clinically significant. Future studies with long term glycemic endpoints and an active control group are needed to validate this observation.
J.B. Hernandez: Employee; Self; Verily Life Sciences LLC.. A. Armento Lee: None. S. Robertson: Employee; Self; Verily Life Sciences LLC. C. Silver: Employee; Self; Verily Life Sciences LLC. A. Majithia: Employee; Self; Onduo.