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Abstract: Use of a Relational Agent Smart Phone App Aims to Improve Time in Range (TIR) for Youth with Type 1 Diabetes (T1D)

Sophie MacColl, Britaney Spartz, Emily L. DeWit, Brent Lockee, David D. Williams, Mitchell S. Barnes, Mark A. Clements

Background: Youth with T1D struggle to achieve blood glucose (BG) TIR targets. However, their inclination for technology makes a glucose self-management app an ideal intervention. We aimed to improve TIR using a relational agent smart phone app. The Happy Bob (HB) app uses Dexcom Continuous Glucose Monitor (CGM) data with personified nudges to gamify engagement for users in BG monitoring.

Method: We collaborated with HB developers to customize an app for youth ≥12 years old with T1D, who use Dexcom and a smartphone. We analyzed participants’ CGM data 28-days pre- and post-enrollment and required at least 7-days of wear time in both 28-day periods.

Results: For a cohort of N=31, average %TIR was (Mean±SD) 54.35±23.61 vs 56.32±22.54 pre- to post-intervention (p=0.3560), with % low and very low showing modest changes (Table 1). We further divided the cohort into 2 groups: those with a change in TIR <5.0% (n=22) vs those with a change ≥5.0% (n=9). Notably, the ≥5.0% group had lower %TIR values pre-intervention compared to the <5.0% group (33.56±11.63 to 62.86±22.00; p=0.0008) and showed an average increase in TIR of 15.1%.

Summary: In this pilot cohort, TIR values did not improve from pre- to post-intervention Future work should examine whether HB has a positive impact when bundled with additional interventions like remote patient monitoring.

 

Table showing CGM outcomes before and after the Happy Bob intervention. Participants demonstrated higher time in range and reduced time spent in low and very low glucose ranges following the intervention

Disclosure

S.Maccoll: None. B.Spartz: None. E.L.Dewit: None. B.Lockee: None. D.D.Williams: None. M.S.Barnes: None. M.A.Clements: Consultant; Glooko, Inc., Research Support; Dexcom, Inc., Abbott Diabetes.

Link: https://doi.org/10.2337/db23-1142-P