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Article History

Received: 19 June 2025

Accepted: 25 November 2025

First Online: 13 February 2026

Acknowledgements

: We thank P. Herrero, R. Biven, A. Moritz, H. J. Grinwis, G. Bogaarts, J. Kober and L. Rouchon, Roche employees, for the scientific, technical and conceptual review and input to the manuscript. Exercise icons in the graphical abstract were designed by Freepik ( ). mySugr is a trademark of Roche. Parts of this work have been presented at the ADA 85th Scientific Sessions in Chicago, IL, USA, as well as the EASD Annual Meeting 2025 in Vienna, Austria.

: Anonymised data, without any demographic identifiers, underlying the results and analysis can be made available to researchers upon reasonable request to the corresponding author after publication. A data access agreement needs to be signed in advance.

: This study was funded by Roche.

: JZ, MM, DT and TG declare financial competing interests and are employees of Roche at the time of writing the manuscript. These authors declare no non-financial competing interest. OM reports receiving the following support: clinical trial support from Sêr Cymru II COFUND Fellowship/European Union, Novo Nordisk A/S, Novo Nordisk AT, Abbott Diabetes Care, Sanofi, Dexcom, Team Novo Nordisk, SAIL, Maisels Brauerei, Medtronic AT, EFSD/EASD, Falke, BISp, perfood, Ypsomed and Sinocare; presenters' honoraria from Medtronic AT, Medtronic Int., Eli Lilly, Novo Nordisk, Sanofi, TAD Pharma, ADA, Diatec, Berufsverband Deutscher Internistinnen, Dexcom, Astra Zeneca, Ypsomed, Insulet, Diabetologen Hessen and Abbot; and conference travel support from Novo Nordisk A/S, Novo Nordisk AT, Novo Nordisk UK, Medtronic AT, Sanofi, EASD, OEDG and DDG. OM is a member of the advisory board at Sanofi, TAD Pharma, Dexcom, perfood, Medtronic.

: JZ, MM, DT and TG developed the ideation of the manuscript and the RWD study design. JZ and MM suggested and performed the statistical analyses. All authors contributed to the data interpretation. JZ wrote the first version of the manuscript, which was edited, critically reviewed and finalised by all other authors. All authors approved the final version. JZ is responsible for the integrity of the work as a whole.