Table 1.

Description of GlycoLeap program components and recommendations for engagement.

Component	Description	Recommended frequency
Online health lessons on diabetes and self-management	A total of 24 educational lessons on diabetes and self-management were delivered online. This curriculum was adapted for the local population and covers topics that take reference from the 7 healthy self-care behaviors as described by the American Association of Diabetes Educators. Quizzes tested knowledge on diabetes, obtained information about participants’ lifestyle habits, and were designed to keep participants engaged throughout each lesson.	Complete one lesson (lasting about 15 minutes) per week
Blood glucose monitoring	Blood glucose measurements obtained using the Accu-Chek Performa glucometer kit were input manually by participants into their Glyco app accounts.	At least 4 blood glucose logs per week (preferably paired pre- and postmeal readings)
Weight monitoring	Wireless weighing scale readings were automatically synced to participants’ accounts via cellular connectivity (3G).	At least one weight log per week
Meal logging	Meal photos taken by participants were uploaded onto the app for health coach evaluation. Health coaches rate meals using a 1 to 5 linear scale. Meal scores are awarded based on the balance of nutrients, food quality, and nutritional content. The meal scores take reference from the Singapore Health Promotion Board’s national dietary guidelines.	No recommendation was provided. Participants were encouraged to log as often as they wanted to.
Physical activity tracking	The Glyco app tracks the number of daily steps taken using the participants’ built-in phone pedometers.	70,000 steps per week
Health coach	Health coaches rate and respond to all meal logs and regularly send messages to participants to provide recommendations, encouragement, and personalized feedback on progress and answer participants’ questions (Multimedia Appendices 6 and 7). Correspondence is 2-way and participants are free to initiate or respond to messages from their health coach. All correspondence is conducted in-app, and all participants receive health coaching regardless of whether they send any messages to their health coach. Coaches capitalize on modalities that have been shown to lead to effective behavior change [20,21], including several theoretical frameworks [22-25], and are trained in the nutrition care process [26].	No recommendation was provided. Participants were encouraged to engage as often as they wanted to.