12600 Predictors Of Diabetes Remission: The Impact Of Early Intervention Through A Digital Twin Platform

Abstract

Abstract Disclosure: S.R. Joshi: None. M. Dharmalingam: None. A. Vadavi: None. A. Keshavamurthy: None. S. Bhonsley: None. M. Thajudeen: None. A. Balasubramanian: None. M. Panandikar: None. P. Shamanna: None. Introduction and Objective: Digital twin (DT) platform uses Artificial Intelligence (AI) and Internet of Things, to integrate multi-dimensional data for precision nutrition and health recommendations via the mobile app. We aimed to identify the pre-intervention anthropometric and biochemical parameters that predict diabetes remission (HbA1c < 6.5% without medications for over 3 months). Methods: 209 patients with T2D completed 540 days (18 months) of DT intervention. Results: 129 (61.7%) achieved remission of T2DM (R group). At baseline, patients in R group, compared with patients in the Non-remission Group (group NR) (n=80) had shorter duration of diabetes (yrs) (R: 2.9±2.6, 95% CI 2.5 to 3.4) vs. (NR: 4.7±2.2, 95% CI 4.2 to 5.2), p= <0.0001; lower baseline HbA1c % (R: 8.6±1.9, 95% CI 8.3 to 9) vs. (NR: 9.5±1.7, 95% CI 9.1 to 9.9), p=0.0008; lower estimated HbA1c (eA1C) (R: 7.6±2.2, 95% CI 7.2 to 8) vs. (NR: 8.9±2.3, 95% CI 8.4 to 9.4), p= <0.0001; lower glucose management indicator (GMI) % (R: 7.5±1.6, 95% CI 7.2 to 7.8) vs. (NR: 8.4±1.8, 95% CI 7.9 to 8.8), p=0.0006; ; lower Time Above Range level 1 (TAR1 %; target 180-250 mg/dl < 25% time) (R:21.3±17.6, 95% CI 18.2 to 24.4) vs. (NR: 31.2±17.2, 95% CI 27.3 to 35), p<0.0001; lower Time Above Range level 2 (TAR2 %; target >250 mg/dl < 5% time) (R: 15±24.5, 95% CI 10.8 to 19.3) vs. (NR: 24.2±26.3, 95% CI 18.2 to 29.9), p=0.01; higher Time In Range (TIR; target 70-180 mg/dl >70% time) (R: 59.5±31.5, 95% CI 54 to 65) vs. (NR: 43.3±30.9, 95% CI 36.4 to 50.2), p=0.0003; lower fasting plasma glucose (mg/dl) (R: 161±53.4, 95% CI 151.7 to 170.3) vs. (NR: 186.4±69.3, 95% CI 171 to 201.8), p=0.003; higher HOMA2B (%) (R: 56.6±31.7, 95% CI 51.1 to 62.1) Vs (NR: 43.6±27.5, 95% CI 37.4 to 49.6), p=0.002; and comparable fasting insulin (mIU/L) (R: 13.9±10.1, 95% CI 12.2 to 15.7) vs. (NR: 11.8±7.2, 95% CI 10.2 to 13.4), p=0.09 (ns), HOMA2IR (%) (R:1.9±0.93, 95% CI 1.8 to 2.1) vs (NR:1.8±0.84, 95% CI 1.6 to 2), p=0.33 (ns); weight (kg) (R:78.9±14.4, 95% CI 76.2 to 81.6) vs (NR:78.1±12.8, 95% CI 75.3 to 81), p=0.71 (ns). The mean baseline anti-diabetic drug count was lower in R (1.4) Vs NR (2.1). At 540 days the change was as follows: comparable Time Below Range1 - TBR1 %(< 70-54 mg/dl) < 4% (R: 3.5±14.9, 95% CI 0.92 to 6.1) Vs (NR: 1.9±8.3, 95% CI 0.07 to 3.8), p=0.38 (ns); lower HbA1c (R: 5.9±0.35, 95% CI 5.8 to 6) Vs (NR: 7.2±1.1, 95% CI 7 to 7.5), p<0.0001. Conclusion: Shorter diabetes duration, lower baseline HbA1c, eA1C, GMI, and TAR, higher TIR, lower fasting plasma glucose, and higher beta-cell function are key predictors of diabetes remission. Presentation: 6/3/2024