We conducted a prospective, multicenter randomized controlled trial (RCT); the trial was registered with the Chinese Clinical Trial Registry (ChiCTR1800015963). We recruited participants from four tertiary care hospitals—West China Hospital, Chengdu Second People’s Hospital, Chengdu First People’s Hospital, and Chengdu Branch in Tibet of Huaxi Hospital Affiliated with Sichuan University—in Chengdu, China, through advertising or from endocrinology clinics from September to October 2018. After telephone screening, eligible participants were invited to an orientation session, in which detailed information about the study was provided to potential participants, and informed consent forms were signed by individuals who agreed to participate. Participants aged 18 to 64 years old were included if they met all of the following criteria:

Their type 2 diabetes diagnosis was confirmed with an oral glucose tolerance test after recruitment into the study.

They had been diagnosed with diabetes 10 years or less prior to the study.

They had access to a smartphone that was capable of running the app used in the study.

We used American Diabetes Association criteria for the diagnosis [6], and we chose a limit of 10 years or less since their diabetes diagnosis in order to exclude individuals with advanced diabetes. In addition, individuals with any of the following conditions were excluded:

Fasting plasma glucose level greater than 16.7 mmol/L.

Recurring hypoglycemia.

A history of acute diabetic complications, including diabetic ketoacidosis, hyperosmolar hyperglycemia, and lactic acidosis.

A history of severe chronic micro- or macrovascular complications.

Diseases that may be exacerbated by exercise or influence exercise efficiency, such as uncontrolled hypertension, hyperthyroidism, osteoarthritis, or hypokalemia.

Another medical condition that was judged by the researchers to preclude participation.

The study was approved by the Research Ethics Board of the West China Hospital of Sichuan University.

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