Background and Aim: Glycemic variability (GV) has shown association with higher risk of diabetes-related complications and increased cardiovascular events in people with T2DM. Personalized glycemic response (PGR) refers to differences in postprandial glycemic response between two people after consumption of the same food. Understanding of PGR after meals can help in improving glycemic control. The study aims at assessing the real-world effectiveness of the PGR based Fitterfly Diabetes CGM program to reduce GV among people with T2DM. Methods: De-identified data of 220 participants (mean age: 48.8 ± 12.8 years, female: 35.9 % (79/220)), enrolled in the Fitterfly Diabetes CGM program was analyzed. CGM access was provided in the first 14 days of the program. In week-1, the users followed their usual lifestyle where blood sugar readings were correlated with meals and other lifestyle data to understand the PGR of each user. A modified lifestyle plan was introduced in week-2 and was followed till the end of the program. Mean blood glucose (mg/dL), TIR, TAR, TBR, glucose management indicator (GMI), and the percentage coefficient of variation for glucose (CV) were analyzed in week-1 and week-2. All data has been represented as median (IQR). Results: After 7 days, the median mean blood glucose and TAR significantly reduced by -4.3 (-14.8, 3.3) mg/dL (P<.001) and -2.5 (-11.6, 5.2) % (P<.001) from week-1 baseline of 130.4 (104.4, 169.7) mg/dl and 15.1 (2.8, 36.8) % respectively. The median TIR significantly increased by 1.7 (-2.8, 7.0) % from a baseline of 77.7 (57.2, 89.9) % (P=.001). The median GMI and CV was significantly reduced by -0.1 (-0.3, 0.1) % (P<.001) and -0.7 (-3.4, 1.8) % (P=.005) from baseline of 6.4 (5.8, 7.4) % and 26.9 (22.9, 31.9) % respectively. No significant change was observed in median TBR (P=.40). Conclusion: The study showed significant improvement in glycemic control and GV after 7 days of PGR-based guidance on the Fitterfly Diabetes CGM program. Disclosure R.Verma: Employee; Fitterfly Healthtech Pvt Ltd. S.Guntur: Employee; Fitterfly Health Tech Pvt. Ltd. A.K.Singal: Employee; Fitterfly Healthtech Pvt Ltd. M.A.Khader: Employee; Fitterfly Health Tech Pvt. Ltd. T.Lathia: None. S.R.Tanna: None. S.A.Patange: None. K.Samudra: None. R.M.Rohatgi: None. M.S.Chitale: None. R.M.Ranadive: Employee; Fitterfly Health Tech Pvt. Ltd. Funding Fitterfly Healthtech Pvt. Ltd.

Background: Digital therapeutics platforms provide accessible and multidisciplinary care for the management of T2D. The current study explored the effectiveness of the Diabefly program for improving glycemic control in people with T2D. Methods: Diabefly program provides a combination of mobile application, remote lifestyle coaching, live video consultations by experts (psychologist, physiotherapist and nutritionist) , and digital logging of parameters. The outcome of the study was to evaluate the change in HbA1c, fasting blood sugar (FBS) , postprandial blood sugar (PPBS) , weight, and body mass index (BMI) at the beginning and end of the program. All the outcomes were evaluated using paired t-test with P<0.considered as significant. Results: A significant mean reduction in HbA1c levels by 1.69 ± 1.91% from a baseline of 8.66 ± 2.05% was observed (P<0.001) . Among all the participants, 93.02% (160/172) showed a reduction in their HbA1c, out of which 56.25% (90/160) showed a HbA1c reduction of more than 1%. Similarly, weight and BMI were also significantly reduced by 2.59 ± 3.31 kg and 0.92 ± 1.15 kg/m2 from a baseline of 75.94 ± 16.24 kg and 27.49 ± 4.71 kg/m2 respectively (P<0.0for both) . Among all the participants, 70.34% (121/172) reduced their weight, out of which 32.23% (39/121) showed a weight reduction of at least 5 kg. Among participants (n=42) with complete FBS and PPBS data, a significant mean reduction by 51.44 ± 58.87 mg/dL and 90.90 ± 78.96 mg/dL from a baseline of 164.87 ± 63.83 mg/dL and 227.95 ± 82.34 mg/dL was observed respectively (P<0.0for both) . Conclusion: Effective glycemic control and significant weight reduction was achieved at the end of the program. Thus, Diabefly program can help in providing continuous support to implement lifestyle changes between quarterly doctor visits and greater usage of a remote lifestyle coaching can be a useful adjunct to doctor’s prescription for holistic management of diabetes. Disclosure R. Verma: Employee; Fitterfly Healthtech Pvt Ltd, Wellthy Therapeutics Pvt Ltd. M.A. Khader: Employee; Fitterfly HealthTech Pvt Ltd. T. Lathia: Advisory Panel; Abbott, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Novartis Pharmaceuticals Corporation, Novo Nordisk, Sanofi. S. Guntur: Employee; Fitterfly Health Tech Pvt. Ltd. A.K. Singal: Other Relationship; Fitterfly Healthtech Pvt Ltd.

Background: Retrospective evaluation of glycemic responses correlated with lifestyle habits can help in mapping personalized glycemic responses (PGR) for individuals. PGR can aid in more specific nutritional interventions in individuals with diabetes ultimately aiding in better glycemic control and weight management. Methods: Participants (n=108, mean age 47.24± 12.28 years, 55.5% females) were enrolled in PGR based Diabefly program and were provided with support for lifestyle modification through a combination of expert led care and mobile application. The outcomes were analyzed at the beginning and end of the program. Paired t-test was used for analysis with P<0.considered as statistically significant. Results: After the program, the daily mean calorie intake significantly reduced by 9.34 ± 30.3 % from a baseline of 1466.93 ± 408.16 cal (P<0.001) . Similarly, the daily mean carbohydrate and fat intake significantly reduced by 10.44 ± 31.99 % and 7.95 ± 39.90 % respectively (P<0.0for both) . The daily mean fiber intake improved by 4.74 ± 44.9 % from the baseline (P=0.26) . Further, the mean energy attributed from protein showed a significant increase by 10.36 ± 25.31 % (P<0.001) . Among participants (n=66) who provided complete data of body weight, BMI, and HbA1c a significant reduction was observed by 3.41 ± 3.33 kg, 1.16± 1.kg/m2, and 2.02 ± 1.73% from a baseline of 76.42 ± 16.61 kg, 27.34 ± 4.40 kg/m2, and 8.78 ± 1.90 % respectively (P<0.0for all) . Waist circumference in participants with complete data (n=53) showed a mean reduction by 4.85 ± 4.45 % from the baseline of 100.3 ± 14.1 cm (P<0.001) . Conclusion: Significant change in dietary behavior was observed after the completion of the program. Effective weight reduction, waist circumference reduction, and improved glycemic control was also observed suggesting the potential of understanding PGR in an effective manner through the Diabefly program for improved outcomes. Disclosure R.Verma: Employee; Fitterfly Healthtech Pvt Ltd, Wellthy Therapeutics Pvt Ltd. A.K.Singal: Other Relationship; Fitterfly Healthtech Pvt Ltd. M.A.Khader: Employee; Fitterfly HealthTech Pvt Ltd. R.M.Ranadive: Employee; Fitterfly Healthtech Pvt Ltd. S.Budyal: None. A.A.Saraf: None. V.Raskar: None. A.Sarwate: None. M.V.Joshi: None. S.Joshi: Consultant; Fitterfly Health Tech Pvt Ltd, Wellthy Therapeutics Pvt Ltd.