In an extraordinary advancement for Type 2 Diabetes (T2D) management, Dr. Francesca Cavallo and Professor Christofer Toumazou have spearheaded the development of a novel mobile health (mHealth) application, as detailed in their recent publication in PLOS Digital Health. This groundbreaking application uses wireless technology in healthcare to catalyze behavior change, thereby enhancing health outcomes. Distinct from conventional mHealth applications, this tool integrates behavioral theory and personalization, elements that are key to driving successful behavior change but often overlooked in digital health interventions.

Dr. Cavallo, discussing the application’s innovative design, stated, “The system exploits the ever-increasing availability of health data from wearable devices, point-of-care tests, and consumer genetic tests to issue highly personalized physical activity and sedentary behavior recommendations.” This statement underscores the depth of customization and user-centric approach that differentiates this application from its predecessors.

The core of the application’s success lies in its foundation in the Behavioural Change Wheel and the Capability-Opportunity-Motivation model. The system begins by categorizing users into one of four diabetes clusters based on their cardiometabolic profile. Professor Christofer Toumazou adds insight into this process, noting, “To provide the personalized recommendations, the system firstly classifies the user into one of four diabetes clusters based on their cardiometabolic profile.” This method ensures that each user’s guidance is specifically tailored to their individual health needs.

An innovative feature of the application is the incorporation of leptin as a feedback biosignal to further customize recommendations. Dr. Cavallo elaborates, “Leptin, a hormone involved in metabolism, is included as a feedback biosignal to personalize the recommendations further.” This marks the first time a biomarker has been integrated in this manner for behavioral change interventions.

The effectiveness of this pioneering system was tested through simulations with data from diabetic participants of the UK Biobank. The results suggest an encouraging potential for increasing activity levels over time in users. The application’s cluster analysis identified four unique T2D clusters, each with varying cardiometabolic profiles and associated risks for developing CVD.

Despite its breakthrough nature, the system has certain limitations, which Dr. Cavallo acknowledges: “The system is evaluated through computer simulations rather than through a randomized controlled trial, which is the gold standard to assess the efficacy of an intervention.” This points to the necessity of further real-world trials to fully evaluate the system’s impact on behavior and health outcomes.

In summary, the mHealth application developed by Dr. Francesca Cavallo and Professor Christofer Toumazou represents a significant leap forward in personalized healthcare. By combining advanced technology with personalized medicine, it offers a promising new approach to managing chronic conditions such as T2D, heralding a new chapter in digital health interventions.

Journal Reference

Francesca Romana Cavallo, Christofer Toumazou Personalised lifestyle recommendations for type 2 diabetes: Design and simulation of a recommender system on UK Biobank Data”, PLOS Digital Health, 2023. DOI:

About the Authors

Dr. Francesca Romana Cavallo


Dr. Francesca Romana Cavallo is a Senior Data Scientist at Optum UK, with a notable academic background from Imperial College London where she completed her Ph.D. in the Centre for Bio-Inspired Technology. Her research has been primarily focused on patient-centered technologies for personalized healthcare, encompassing areas such as biosensors, point-of-care tests, machine learning, and statistics for tailored medicine. Additionally, her work includes studies on lifestyle influences on human health and developing knowledge-based systems for personalized lifestyle recommendations. Dr. Cavallo’s expertise in health data science has been instrumental in advancing the field of personalized medicine and healthcare technology, demonstrating her commitment to improving healthcare outcomes through data-driven approaches.

Professor Christofer Toumazou

Imperial College London

Professor Christofer Toumazou is a preeminent figure in biomedical engineering at Imperial College London, serving as the Regius Professor of Engineering, Chair in Biomedical Circuit Design, and Director of the Centre for Bio-Inspired Technology. He is also the Founder and Chief Scientist for the Institute of Biomedical Engineering at the same institution. Born on July 5, 1961, Toumazou is a British Cypriot electronic engineer. Remarkably, he was appointed as the youngest Professor at Imperial College at age 33 in 1994 and became London’s first Regius Professor of Engineering in 2013. His groundbreaking work in biomedical engineering, diagnostic innovations, and personalized medicine has revolutionized healthcare, earning him international accolades, including the UNESCO-Equatorial Guinea International Prize, making him the first UK recipient of this award. His career is marked by significant contributions and innovations that have pushed the boundaries of medical engineering.