An app providing personalised cognitive behavioural therapy to people with type 2 diabetes helped users to significantly reduce their blood sugar levels.

The study also found that participants using the app for six months had less need for greater doses of diabetes medications, and that they also reported improvements in areas including depression and quality of life.

The app, which delivered at least one lesson a week on skill development and behaviour change, is one of the first to show evidence of effectiveness in reducing blood sugar.

Dr Marc P. Bonaca, professor of medicine and director of vascular research at the University of Colorado School of Medicine, said: “Much of diabetes stems from unhealthy behaviours – making poor food choices, overeating, stress eating, not exercising – that are generally rooted in unhelpful patterns of thinking and modes of coping with environmental stresses.

“CBT has been shown to be effective at helping people develop the skills to recognise the unhelpful thoughts and beliefs that trigger their unhealthy behaviours and to establish healthier patterns of thinking and behaviour.”

The research also showed that the more CBT lessons a participant completed, the greater the benefits.

The study involved 668 people with diabetes, with the group having an average age of 58. The participants’ average body mass index was 35 – a BMI of 30 or higher is classed as being obese.

Half of the group were given access to the CBT app – called BT-001 – while the other half used a control app, which did not deliver tailored lessons.

After three months, those using the BT-001 app had achieved a reduction of 0.4% in their HbA1c, a measure of average blood sugar over the last two to three months. This reduction is similar to the reduction that is seen with most antihyperglycemic medications.

This reduction was maintained at six months and more participants in the BT-001 app group were able to lower their insulin dose or stop it altogether. The control group, however, saw more people start or increase their insulin dose.

Dr Bonaca said: “When studied in a large randomised controlled trial, digital CBT tailored to the individual reduced blood sugar levels, while also reducing the need for intensified medication use and improving blood pressure and body weight.

“We saw a clear dose effect with digital CBT. That is, the antihyperglycemic effect increased in direct proportion to the number of lessons participants completed. The more lessons they did, the greater the reductions in HbA1c they achieved. Participants aged over 75 did as well as younger patients if they completed the same number of lessons.”

The app was used, on average, for six minutes a day.

The study was presented at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology.

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