Accepted for/Published in: JMIR Diabetes
Date Submitted: Mar 28, 2023
Date Accepted: Aug 16, 2023
Date Submitted to PubMed: Aug 17, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Impact of a Combined Continuous Glucose Monitoring – Digital Health Solution on Glucose Metrics and Self-Management Behavior for Adults with Type 2 Diabetes: Retrospective, Real-World Study
ABSTRACT
Background:
Digital health solutions for diabetes management have been shown to improve glycemic outcomes but there are limited data on program engagement. The Welldoc® BlueStar® digital health solution incorporates data from multiple devices and generates coaching messages using artificial intelligence (AI). The BlueStar app syncs glucose data from the Dexcom G6 real-time continuous glucose monitoring (RT-CGM) system, which provides a glucose measurement every five minutes. This real-world study of individuals with type 2 diabetes (T2D) using BlueStar and RT-CGM for three months evaluated glycemic outcomes and engagement with the digital health solution.
Objective:
We aimed to assess glycemic metrics and rates of engagement with the BlueStar app in people with T2D using RT-CGM and the BlueStar digital health solution.
Methods:
Participants were current or former enrollees in an employer-sponsored health plan, were 18 years of age or older, had a T2D diagnosis, and were not using prandial insulin. CGM-based glycemic metrics were obtained and engagement with the BlueStar app, including event logging rates, was measured.
Results:
Participants in the program that met our analysis criteria (n=52) were 53 (9) (mean (SD)) years of age, 37% female, and approximately 50% were taking anti-diabetes medications. The RT-CGM system was worn 90% (8%) of the time over three months. Among individuals with baseline mean glucose >180 mg/dL, clinically meaningful improvement in glycemic metrics was observed including increased time in range 70-180 mg/dL (+25.3 percentage points; p<0.01) and time above range 181-250 mg/dL (-9.7 percentage points; p<0.05) and >250 mg/dL (-15.9 percentage points; p<0.05). Over the three-month study, 29% of participants completed at least one engagement activity per week. Medication logging was completed most often by participants (44%) at a rate of 12.1 (0.8) events/week and this was closely followed by exercise and food logging.
Conclusions:
The combination of an AI-powered digital health solution and RT-CGM helped people with T2D improve their glycemic outcomes and their diabetes self-management behaviors.
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