The effect of education in obese type 2 diabetes adolescents and young adults based on continuous glucose monitoring and smartwatch-derived lifelog data.

PURPOSE: The increasing prevalence of type 2 diabetes (T2D) among adolescents and young adults (AYAs) is a major public health concern worldwide. This pilot study evaluated the effectiveness of lifestyle education in managing T2D in obese AYAs using continuous glucose monitoring (CGM) and smartwatch-derived lifelog data. METHODS: Seven obese AYAs and T2D aged 12-19 years were enrolled in this prospective interventional study. Patients continued to take their previously prescribed T2D medication. CGM data were collected for 10 days, followed by lifestyle education using CGM and smartwatch data. Outcomes, including anthropometrics, glycemic control, dietary intake, physical activity, and self-management skills, were reassessed after an additional 10 days. RESULTS: The median time in range increased from 58.1% (53.2%-75%) to 72% (64%-88%) (p=0.043) and time above range (>250 mg/dL) decreased from 10% (2.9%-18.6%) to 3.0% (1.0%-11.0%) (p=0.028). Median peak total caloric intake decreased from 2,854 (2,465-3,040) kcal/day to 2,091 (1,751-2,283) kcal/day and walking calorie expenditure increased from 163.9 (116.7-321.3) kcal/day to 180.2 (165.3-492.4) kcal/day (p=0.018 for both). The Summary of Diabetes Self-Care Activities score improved from 0.29 (0.05-0.43) to 0.33 (0.32-0.68) (p=0.043). CONCLUSION: This integrated approach combining CGM and smartwatch-based education exhibited short-term effects on glycemic control, dietary habits, physical activity, and self-management skills in obese AYAs and T2D. Further studies are needed to confirm the long-term effectiveness of this strategy in this challenging population.