Gamifying Diabetes


Can we borrow elements of gaming apps to help patients better engage with their diabetes?

Humans love a challenge, especially one that summons a sense of competition. Look at the innumerable games that are available on your phone, tablet, or desktop, with just a click. I’m sure you’ve noticed the trance-like facial expressions, as individuals stare at their screens while playing these games (or while checking their e-mail, scanning the day’s headlines, reading blog posts, or any one of the seemingly limitless tasks we carry out on these devices)!

Can we borrow some of the elements of these games to help patients better engage with their diabetes, while they perhaps even enjoy the process? It turns out, we can.

I’m certainly not suggesting that gamification diminishes the seriousness of diabetes, or that this is the only solution. We need additional resources to help patients not only enhance their knowledge of diabetes self-management, but also to promote a sense of connection with others who are living well with diabetes, and who understand the challenges that patients who may be striving and struggling face firsthand.

Gamification is not the answer to ideal diabetes management, but it probably can’t hurt. Here are 3 examples of gamified diabetes apps, in varying states of availability.

1. HealthSeeker
This free app was released in 2010 and was the first social game for patients with diabetes. The Joslin Diabetes Center, Boehringer Ingelheim, and the Diabetes Hand Foundation partnered with the developer, Ayogo. Before it was discontinued in 2014, approximately 20,000 individuals had experienced this site, which led to “more than 3700 completed missions and more than 42,000 healthy actions . . . taken, including 20,500 healthy meals eaten.”1 The site invited patients to select missions that are geared toward reaching goals, such as optimizing self-monitored blood glucose (SMBG) levels, decreasing weight, or improving what they eat. There was a prominent social aspect-it drew on a participant’s Facebook friends network and allowed users to share their missions, inform their friends when they had completed missions, and mutually exchange what the developers term “virtual kudos” when they had attained goals.

2. Fit2Me
Launched in 2015, AstraZeneca’s site gives patients the opportunity to choose a coach-one of 6 individuals-to guide them through plans for optimizing food choices and physical activity and to offer tips on working with their physicians, based on information the individual enters.2 While there’s no social facet, the interactions with the coach provide a substitute for this. Ayogo also developed the platform and notes on their website that “adding delightful, humorous and unexpected elements to the activation process can give users the encouraging feeling that they are having fun, even when providing information.”

Here’s one of the coach descriptions on the Fit2Me website:

For Tim, the best way to create new habits is to make them fun. There’s no reason serious changes have to feel that way. As a surfer, it’s only natural for him to take a relaxed approach. Want a positive outlook to help create healthy habits . . . that’s Tim.

3. COPEDS Black-Belt App, a.k.a. Ninja
This last example is being developed (hence the app does not have an official title) by Jennifer Dyer, MD, MPH, of the Central Ohio Pediatric Endocrinology and Diabetes Services (COPEDS). The site will bring together multiple open-source games selected by adolescent beta-testers. The challenge: to advance to black-belt status by testing SMBG levels 4 times per day or by administering fast-acting insulin at meals at least 3 times daily. Dr. Dyer will be incorporating a feature to permit physicians and other health care team members to track their patients’ progress on the site.

She told about the decreased use over time of her earlier apps: “Turned out it’s because diabetes is hard, and ultimately everybody who’s doing it well and thriving has an automatic habit of doing these things. It’s kind of like brushing your teeth or other self-care tasks, you just do them.”3

One of the challenges with apps is that the novelty can wear off. How can this and other potential stumbling blocks be addressed?

This is a brief tour of past, present, and future apps to help engage patients with diabetes, and there are other apps out there-either currently being used or still in the works. Let’s hope the future brings more apps that are easy and enjoyable to use while aiding patients as they strive for living at goal and better quality of life.


Dr. Chao does not have any conflicts of interest relevant to any of the companies noted in this article.


1. Kamel Boulos MN, Gammon S, Dixon MC, et al. Digital games for type 1 and type 2 diabetes: underpinning theory with three illustrative examples. JMIR Serious Games. 2015;3:e3.

2. Fit2Me. Accessed July 2, 2017.

3. Hoskins M. Endo’s new ninja app will gamify diabetes management. Diabetes Mine, HealthLine. April 13, 2016. Accessed July 2, 2017.

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