1606-P: Appricate: An Asynchronous Mindfulness-Training Mobile Health Application for Adolescents with Type 1 Diabetes
Kaitlyn Rechenberg, Rebecca Koerner
Diabetes June 5, 2026 DOI: 10.2337/db26-1606-p (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot study Randomized Peer reviewed |
|---|---|
| Sample size | 28 |
| Population | Adolescents aged 12 to 19 years with Type 1 diabetes for more than 6 months |
| Intervention | Appricate |
| Duration | 8-week intervention with post-intervention assessment at 12 weeks |
| Topics | Meditation |
| Key points | Appricate, an 8-week remote mindfulness app, was feasible and acceptable in adolescents with Type 1 diabetes, with over 85% response rate, 70% completion, 20% attrition, and over 85% weekly engagement. Though not powered for efficacy, anxiety symptoms decreased significantly and diabetes-specific quality of life and sleep quality increased significantly; the authors call for a fully powered randomized controlled trial. |
Abstract
Introduction and
Objective: Adolescents with Type 1 diabetes (T1D) report high levels of anxiety symptoms which are associated with poor quality of life (QoL) and out-of-range hemoglobin A1c. Mindfulness-based stress reduction (MBSR) is a manualized, evidence-based treatment for anxiety symptoms. We designed an 8-week, remote, asynchronous mHealth application, Appricate©, delivering mindfulness-training modeled on the MBSR program to adolescents with T1D. We examined feasibility, acceptability and preliminary efficacy of Appricate©.
Methods: We conducted a pilot study of Appricate© in 28 adolescents with T1D. Eligible participants were: (1) aged 12 to 19 years; (2) diagnosed with T1D for > 6 months; (3) read/speak English fluently; (4) had access to a mobile phone. We measured anxiety symptoms, diabetes-specific QoL diabetes self-care, sleep quality, and hemoglobin A1c at baseline and post-intervention (12 weeks). Demographic characteristics were collected at baseline. Changes were evaluated using paired t-tests.
Results: Most participants were female (60.7%), white (75%), non-Hispanic (92.9%), used an insulin pump (96.4%), and had diabetes for three to five years (64.3%). We established feasibility (> 85% response rate, 70% completion rate, 20% attrition rate) and acceptability (>85% weekly engagement) of Appricate©. While not powered to assess efficacy, Appricate© led to a significant decrease in anxiety symptoms (p<0.05) and a significant increase in QoL (p<0.01) and sleep quality (p<0.1).
Conclusion: Appricate© is feasible and acceptable to adolescents with T1D and has promise in improving psychosocial symptoms. Given the established associations between psychosocial and glycemic outcomes, Appricate© has the potential to improve both in adolescents with T1D. A fully-powered randomized controlled trial is needed to determine efficacy. K. Rechenberg: None. R. Koerner: None. National Institutes of Health (K23NR019911)
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |