The emergence of mobile technologies and wearable sensors has enabled real-world monitoring of mobile health biometrics (mHealth). 7 Therefore, in order to provide effective exercise and PA support to individuals with type 2 diabetes, research is needed to develop clinically effective, cost-effective, scalable interventions which bridge the gap between supervised exercise and PA advice. Importantly, a meta-analysis 8 suggests PA advice was not associated with changes in HbA1c in individuals with type 2 diabetes, unless it was combined with dietary advice. 10 Standard provision for individuals with newly diagnosed type 2 diabetes therefore is limited to PA advice alone. 9 However, the resources required to implement supervised exercise are not feasible as part of routine care in many countries. Previous research studies show supervised exercise interventions in individuals with type 2 diabetes are useful as they can increase total PA 7 and reduce glycated haemoglobin (HbA1c) by −0.67% (1.3 mmol/mol), 8 a reduction comparable with that observed with the addition of non-insulin glucose-lowering drugs. 3 4 To address this issue, diabetes care pathways are prioritising personalised exercise and PA advice for those with newly diagnosed type 2 diabetes, (eg, the National Health Service (NHS) Rightcare Pathway in UK 5 and Diabetes 360° 6 in Canada). 2 Nevertheless, individuals with type 2 diabetes are less active and more sedentary than those without. Increasing physical activity (PA: movement that raises energy expenditure), both through exercise (planned and structured PAs with a goal of improving health and fitness) and habitual lifestyle behaviours such as walking and active travel, is fundamental to the initial treatment of type 2 diabetes, 1 and is recommended by international consensus. Correspondence to Dr Matthew Cocks m.s.cocksljmu.ac.uk.9 Department of Musculoskeletal Biology II, University of Liverpool, Liverpool, UK.8 School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.7 Sport and Health Sciences, University of Exeter, Exeter, UK.6 Division of Health Research, Lancaster University, Lancaster, UK.5 Faculty of Medicine, University of British Columbia, Kelowna, British Columbia, Canada.4 Department of Diabetes, Taunton and Somerset NHS Foundation Trust, Taunton, UK.
3 Exeter Medical School, University of Exeter, Exeter, UK.2 School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada.1 Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.