Smartwatches and Apps Help Type 2 Diabetes Patients Stay Active

Wearable mobile health technologies may help individuals newly diagnosed with Type 2 Diabetes (T2D) adhere to physical activity routines, according to a new feasibility trial published in BMJ Open. The study, conducted by researchers in Canada and the United Kingdom, examined whether smartwatches and app-based feedback could assist people with T2D in maintaining moderate-to-vigorous physical activity from home.

The MOTIVATE-T2D trial involved 125 participants aged 40 to 75 years, each diagnosed with T2D between five and 24 months before joining the study. All participants were managing their condition either through lifestyle changes alone or with Metformin, a commonly prescribed first-line medication for T2D.

Increased adherence and promising clinical outcomes

Participants were provided with home-based exercise guidance, including a gradual progression toward 150 minutes of moderate-to-vigorous physical activity per week over 6 months. Those who received additional support through wearable devices, including smartwatches with accelerometers and heart rate monitors, were more likely to initiate and sustain regular physical activity.

These wearables were paired with a web or smartphone app, which shared data with an exercise specialist delivering behavioral support virtually. Participants could track their progress and receive feedback based on biometric data such as heart rate.

Over the 12-month trial, researchers observed improvements in markers of cardiometabolic health, including reduced blood glucose levels and lower systolic blood pressure. Secondary outcomes suggested potential improvements in cholesterol levels and self-reported quality of life.

A cost-conscious, scalable model

The study also included an economic evaluation led by researchers at Lancaster University, who assessed the cost-effectiveness of wearable-supported programs compared to usual care. The researchers note that such non-pharmacological interventions could support equitable access to T2D management tools, particularly where in-person resources are limited.

The MOTIVATE-T2D programme did not require gym access. Instead, it offered a range of workouts, including cardio and resistance training, that could be performed at home. The goal was to help participants integrate exercise into their routines in a sustainable way, potentially improving both physical and mental health outcomes.

Feasibility trial supports further investigation

The 82% retention rate over 12 months and consistent participant engagement indicate the potential for broader application of wearable-supported, home-based interventions in diabetes care. The authors suggest that further large-scale studies could help determine the long-term clinical and economic impacts of this approach.

Reference: Hesketh K, Low J, Andrews R, et al. Mobile health biometrics to enhance exercise and physical activity adherence in type 2 diabetes (MOTIVATE-T2D): a decentralised feasibility randomised controlled trial delivered across the UK and Canada. BMJ Open. 2025;15(3):e092260. doi: 10.1136/bmjopen-2024-092260

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