Beta-cell Evaluation Through Data-driven Assessments (BETA): Study in Prediabetes Type 2 Diabetes

The objective of this research is to construct a real-time, non-invasive predictor of pancreatic beta-cell function for individuals with T2D or prediabetes, using data from a CGM alongside a diverse array of health, lifestyle, and behavioral metrics gathered via a smartphone app and Oura Ring. Investigators will study individuals with T2D or prediabetes using remote digital tools to determine the risk of conversion from prediabetes to T2D as it relates to beta-cell function, as well as personalized treatment options for individuals with Type 2 diabetes. Participants will undergo detailed evaluations of pancreatic beta-cell function at the Buck Institute's Clinical Research Unit (CRU) using the Minimal Model Oral Glucose Tolerance Test (OGTT) with analysis of C-peptide, glucose and insulin levels, and a Meal Tolerance Test (MTT) at the end of the study. Participants will complete 4 at-home real-world challenges that will also involved MTTs with or without a controlled psychological stress test that will be administered to you by research staff. From this data, the investigators can calculate clinical measures of beta-cell function, including oral Disposition Index as well as the Homeostatic Model Assessment of beta-cell function (HOMA-B), and beta-cell glucose sensitivity. This hybrid approach, blending advanced digital data acquisition with traditional clinical assessments, will facilitate the identification of critical data patterns and biomarkers correlating with beta-cell function. The envisioned outcome is a scalable tool for early identification of individuals experiencing a decline in beta-cell function.