Abstract Disclosure: S.R. Joshi: None. J. Mohammed: None. M. Mohamed: None. T. Poon: None. M. Dharmalingam: None. B. Saboo: None. S. Damodharan: None. A. Vadavi: None. M. Thajudeen: None. A. Keshavamurthy: None. S. Bhonsley: None. B. R: None. P. Shamanna: None. Background and Aims: The aim was to study the effect of a personalized diet using the Digital Twin (DT) on the concurrent effect on visceral fat and glycemic control through CGM parameters. The personalized food recommendations were provided through the mobile app. Materials and methods: DT uses a machine learning algorithm to integrate clinical and sensor data. USFDA approved Powermax BCA-130 Bluetooth Smart Scale, was used for assessment. Results: Visceral fat data was categorised as three levels (normal 1 to 9%; high 10 to 14% and very high 15 to 30%). At baseline 94 (46.3%) had normal level of visceral fat, 80 (39.4%) had high and 29 (14.3%) had very high level of visceral fat. The study participants included 75 individuals with visceral fat % levels shifting from high (11.7+1.4) to normal (8.8+1.0) (p<0.001), 12 from very high (17.2+2.2) to high (14.0+0.0) (p<0.001) and 11 from very high (18.4+5.9) to normal (8.4+0.9) (p<0.001). DT led to a significant reduction in visceral fat levels in all three levels from baseline. DT also resulted in improved glycemic control. The group shifting from very high to high visceral fat levels experienced the most significant improvement, with a decrease in the mean glucose levels from 213.0+62.4 to 93.0+12.1mg/dl (p<0.001) and eA1C from 9.2+2.2% to 5.0+0.4% (p<0.001). The group shifting from high to normal visceral fat levels also experienced a significant decrease in mean glucose levels from 170.9+65.1 to 85.2+25.6 mg/dl (p<0.001) and eA1C levels from 7.7+2.3% to 4.7+1.0% (p<0.001). The group shifting from very high to normal visceral fat levels also experienced a significant decrease in mean glucose levels from 137.5+46.8 to 81.4+15.9 mg/dl (p<0.002) mg/dl and eA1C levels from 6.5+1.7% to 4.5+0.6% (p<0.002). DT resulted in significant improvement in TIR. The group shifting from very high to high visceral fat levels showed the most substantial improvement, with an increase in TIR from 40.7+35.1% to 88.9+18.8% (p=0.001). The group shifting from high to normal visceral fat levels also experienced a significant improvement, with an increase in TIR from 56.7+13.9% to 75.7+26.9% (p<0.001). The group shifting from very high to normal visceral fat levels had a change in TIR from 72.6+27.7% to 72.5+30.6% (p=0.995). Conclusion: Personalized diet interventions using DT technology can effectively reduce visceral fat levels and improve glycemic control in T2DM with varying degrees of visceral fat levels. Presentation: Friday, June 16, 2023