IDF21-0186 Real-world effectiveness of Diabefly digital therapeutics program for glycemic control during COVID-19 pandemic in India

Abstract

Background: The COVID-19 pandemic led to significant changes in everyday life through lockdowns and home confinement, leading to substantial indirect risk for people with diabetes. The resulting disruptions in the management of diabetes have been attributed to factors like limitations on physical activity, changes in dietary habits, anxiety, and limited access to health care facilities. Clinically validated digital therapeutics platforms have potential towards enabling continuity-of-care during the pandemic. Aim: The study is aimed at examining the effectiveness of Diabefly digital therapeutics program for people with type 2 diabetes (T2D) during the COVID-19 pandemic in India. Method: De-identified data was analyzed for 72 participants with T2D who had completed 90 days on the Diabefly digital therapeutics program during the COVID-19 pandemic since April 2020. The Diabefly program provided personalized glycemic response-based lifestyle management support, educational and motivational content, personalized nutrition plan by nutritionist, and remote health coaching. The program offered access to mobile application-based logging of meals while providing details of calorie intake as well as macro- and micro-nutrient compositions. The program also facilitated logging of clinical and anthropometric parameters like HbA1c, body weight and body mass index (BMI). In this work, the variation in these parameters was analyzed at the beginning (first 7 days) and at the end of the program. Paired t-test was used for statistical comparison between two groups, while Kruskal-Wallis test and Dunn’s multiple comparison test was used for assessing the difference between more than two groups. P<0.05 was considered as statistically significant. Results: The participants had a mean age of 44.44 ± 14.35 years with 32 females (44.44%). The average duration of diabetes was 4.24 ± 6.59 years with the most common comorbidities being hypertension in 20 participants (27.77%) and dyslipidemia in 14 participants (19.44%). After completion of the program, a significant mean reduction in HbA1c of 1.96 ± 2.06% was observed (P<0.0001). Similarly, weight and BMI of participants showed a mean reduction of 2.62 ± 3.33 kg (P<0.0001) and 0.88 ± 1.10 kg/m2 respectively (P<0.0001). After 90 days on the program, 68 participants (94.44%) showed reduction in HbA1c while 55 (76.38%) reduced their body weight when compared to baseline. The group with lesser than median interactions, median interactions, and higher than median interactions showed a median (IQR) reduction of HbA1c by 0.50 (0.95) %, 1.70 (3.47) %, and 1.75 (2.37) %. A significant variation in the HbA1c reduction was observed with different level of interactions with the platform (P=0.03). Group with higher than median interactions showed significantly higher reduction in HbA1c as compared to the group with lower than median interactions (P<0.05). Discussion: There was a significant reduction in HbA1c, body weight, and BMI in participants who completed 90 days on the Diabefly program. Higher interaction with the platform showed higher reduction in HbA1c suggesting the potential of the program for overall improvement in glycemic control. Thus, Diabefly program was used as an effective tool for diabetes self-management, education and support during the COVID-19 pandemic while ensuring continuity-of-care in times of limited access to health care resources.