Youth-onset type 2 diabetes (T2D) represents a growing threat to health equity. T2D diagnosis in childhood often results in severe complications by early adulthood, as well as reduced life expectancy. Modification of diabetes-related health behaviors, including nutrition and physical activity, is central to management, but several barriers exist for adolescents and young adults (AYA) with T2D. Fortunately, wearable continuous glucose monitors (CGMs) enable the development of remote just-in-time adaptive interventions that use real-time data at the right time, in the right context to promote behavior change. With the transition to adult care, AYA with T2D are particularly well suited to benefit from a CGM-supported intervention that supports development of diabetes self-management skills and engagement in health behaviors. To lay the foundation for such an intervention, we have developed Healthmine, a mobile app that integrates CGM, activity trackers, and diet logging for use by individuals with diabetes. The objective for this project is to evaluate the time-dependent glycemic impact of Healthmine app-based prompts. In this study, we will enroll 100 AYA ages 16-24 with T2D in a clinical trial to determine the effects of prompts on short-term CGM-measured glycemia, characterize ongoing CGM and app use and longer-term impact on glycemia during an observational period, and evaluate changes in outcomes. Findings will inform the development of a CGM-based just-in-time adaptive intervention, which will directly address barriers to in-person engagement in health behavior change, allowing for scalability and ultimately reducing the widening health disparities caused by youth-onset T2D.

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This project is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) under award # 1R01DK137803-01A1.