Operational and Clinical Insights from a Fully Decentralized Clinical Study Evaluating Protocol Adherence, Participant Satisfaction, and Connected Device Data in Individuals with Type 2 Diabetes on Different Treatment Regimens

Decentralised monitoring of people with type 2 diabetes using continuous glucose monitoring and a hybrid smartwatch was feasible, with high participant retention and successful collection of glucose, heart rate, activity, sleep and GPS data via a study app.

Exploring Decentralized Glucose and Behaviometric Monitoring of Persons with Type 2 Diabetes in the Setting of a Clinical Trial — Ali et al., Journal of diabetes science and technology (paywalled) · source ↗

• dct
• actigraphy
• wearable
• multimodal
• cgm
• rpm
• self-collection
• digital-biomarker
• interstitial-fluid

In a crossover trial of 23 adults with newly diagnosed type 2 diabetes, a personalised diet based on predicted postprandial glucose responses improved continuous glucose monitoring measures significantly more than a Mediterranean diet, including lower average postprandial glucose response and less time in hyperglycaemia. A six-month follow-up of the personalised diet further improved glycaemic control and metabolic health, supporting its clinical utility for decentralised diabetes management.

Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial — Rein et al., BMC medicine · source ↗

• dct
• multimodal
• cgm
• rpm
• microbiome
• digital-biomarker
• interstitial-fluid

A six-month randomised trial in 225 adults with prediabetes showed that a personalised postprandial-targeting diet, guided by a machine-learning algorithm integrating microbiome data, reduced daily time with glucose above 140 mg/dL and HbA1c significantly more than a Mediterranean diet, with benefits persisting at 12 months. The study illustrates how continuous glucose monitoring and smartphone-based dietary logging can enable patient-centric, decentralised nutritional interventions for glycaemic control.

Personalized Postprandial Glucose Response-Targeting Diet Versus Mediterranean Diet for Glycemic Control in Prediabetes — Ben-Yacov et al., Diabetes care (paywalled) · source ↗

• dct
• multimodal
• cgm
• rpm
• microbiome
• digital-biomarker
• interstitial-fluid

In adults with type 1 diabetes, Dexcom G7 and FreeStyle Libre 3 showed high accuracy during physical activity, whereas the Simplera system was less accurate; this matters for selecting devices in decentralised monitoring.

Performance of three simultaneously used rtCGM systems around a physically active weekend camp in adults with type 1 diabetes: A prospective lab and real-world study — Sanfilippo et al., Diabetes, obesity & metabolism · source ↗

• wearable
• multimodal
• cgm
• blood
• capillary
• interstitial-fluid

In adults with MASLD, sucrose-free brazzein-sweetened ice cream produced smaller postprandial glucose excursions and lower incremental area under the curve over 150 min than sucrose-sweetened ice cream, measured by continuous glucose monitoring.

Effect of sucrose-free brazzein-sweetened ice cream on continuously monitored glycemic response in patients with metabolic dysfunction-associated steatotic liver disease: A randomized controlled double-blind crossover trial — Isakov et al., Clinical nutrition ESPEN (paywalled) · source ↗

• wearable
• multimodal
• cgm
• interstitial-fluid