Be In Control

Effectiveness of daily financial incentives on glucose monitoring adherence and glycemic control in adolescents & young adults with type 1 diabetes.

Charlene Wong, MD, MSHP
Principal Investigator
Alexander Morris, BS
Research Coordinator

The challenge

Glycemic control often deteriorates during adolescence and the transition to young adulthood for patients with type 1 diabetes. The inability to manage type 1 diabetes effectively during these years is associated with poor glycemic control and complications from diabetes in adult life.

The approach / study overview

Objective was to determine the effect of daily financial incentives on glucose monitoring adherence and glycemic control in adolescents and young adults with type 1 diabetes. All participants were given daily blood glucose monitoring goals of 4 or more checks per day with 1 or more level within the goal range (70-180 mg/dL) collected with a wireless glucometer. The 3-month intervention consisted of a $60 monthly incentive in a virtual account, from which $2 was subtracted for every day of non-adherence to the monitoring goals. During a 3-month follow-up period, the intervention was discontinued.

The primary outcome was change in HbA1c levels at 3 months. Secondary outcomes included adherence to glucose monitoring and change in HbA1c levels at 6 months. All analyses were by intention to treat.

Way to Health use

  • Enrollment: Enroll and randomize participants across the study arms

  • Device Integration: Collect data from the devices by patient

  • Rules Engine: Set and monitor activity and achievement vs targets

  • Behavioral Economics: Award cash incentives by study arm

Results / Outcomes

Effectiveness of financial incentives:This area shows promise in the adolescent population which has been traditionally difficult to target.

Improved glucose monitoring: from 18.9% to 50% vs control group

Publications