Background and Aim: Majority of people with Diabetes (PWD) use insulin and sulfonylurea (SU) as a necessary part of treatment regimen for glycemic control. Weight gain associated with these medications becomes a major challenge in effectively managing diabetes. The study evaluates the real-world effectiveness of the Fitterfly Diabetes program for weight management in PWD using antidiabetic medications associated with weight gain and weight loss. Methods: Deidentified data of 79 participants (mean age: 45.4 ± 10.4 years, female: 54.4 %) with T2DM enrolled in the program was analyzed. Out of all participants, 28 people used antidiabetic medications associated with weight gain (thiazolidinediones, meglitinides, SU, and insulin) while 51 participants used antidiabetic medications associated with weight loss (biguanides, sodium-glucose cotransporter-2 inhibitors). Participants using medications from both groups or any other antidiabetic medications were excluded. Data has been shown as the median (IQR). Results: After 90 days, participants using antidiabetic medications associated with weight loss showed reduction in HbA1c, weight, and waist circumference by -0.5 (-1.0, 1.0) %, -3.5 (-6.0, -1.1) kg, -5.0 (-9.0, -1.5) cm from the pre-program baseline of 7.6 (7.1, 8.4) %, 81.0 (68.0, 92.0) kg, and 105.0 (97.0, 110.0) cm respectively (P<0.001 for all). Participants using antidiabetic medications associated with weight gain showed reduction in HbA1c, weight and waist circumference by -1.3 (-2.8, -0.02) %, -2.0 (-3.6, 0.9) kg, -2.0 (-4.7, 0.0) cm from the baseline of 9.6 (8.1, 10.7) %, 73.0 (66.2, 79.4) kg, and 99.0 (92.0, 105.8) cm respectively (P<0.05 for all). Conclusion: Significant reduction in weight, HbA1c, and anthropometric parameters was observed after 90 days on the program irrespective of the effect of antidiabetic medications on weight. PWD looking to lose weight are good candidates for such programs. Disclosure S.A.Patange: None. S.Joshi: Consultant; Fitterfly Health Tech Pvt. Ltd. A.K.Singal: Employee; Fitterfly Healthtech Pvt Ltd. R.Verma: Employee; Fitterfly Healthtech Pvt Ltd. C.Selvan: None. S.Kalra: Speaker's Bureau; Abbott, Bayer Inc., Novo Nordisk, Sanofi. M.H.Tiwaskar: None. V.Methil: None. B.V.Patil: None. F.Malde: None. V.Nair: None. Funding Fitterfly Healthtech Pvt. Ltd.

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: Exercise is an integral aspect for effective diabetes management. Supervised home-based exercise through exercise prescriptions customized based on a person's exercise status, pain complaints and fitness levels can help in better adherence and low risk of injury while reducing unnecessary hospital visits. The study was aimed at the assessment of physical fitness in people with diabetes (PWD) for the development of a personalized exercise plan. Methods: Video-call based assessment of physical fitness was done in 470 participants (mean age 44.9 ± 10.4, 31.7% females) of Diabefly® digital therapeutics platform. Trained physiotherapist conducted the assessment with the corresponding tests: upper limb strength (1-min push up test) , lower limb strength (wall sit test) , core strength (1-min sit up test) , flexibility (V-sit and reach test) and cardiorespiratory fitness (6 minute walk test) . The scores of the tests were obtained through gender and age based normative data. Participants were categorized based on the physical activity (PA) status as non-exercisers (less than 150 mins/week of PA) , aerobic exercisers (performed only walking as PA) , exercisers (combined strength training and aerobic PA >150 mins/week) . Descriptive statistics and ANOVA were performed via SPPS v21. Results: Out of all the participants, 69.4% were in the obese category with 42.1% of participants being non-exercisers, 42.1% were aerobic exercisers while only 15.7% were exercisers. Mild to moderate pain was reported by 36.1% participants. Cardiorespiratory fitness, upper limb strength, core strength and flexibility were significantly lower among non-exercisers as compared to exercisers (P<0.05) . Conclusion: This study showed the feasibility of video call-based physical fitness assessment in PWD. The assessment along with consideration of pain and current exercise pattern will help in development of personalized exercise prescription for PWD. Disclosure M.Bhagat: Employee; Fitterfly Healthtech Pvt Ltd. S.Guntur: Employee; Fitterfly Health Tech Pvt. Ltd. A.S.Mandlekar: Employee; Fitterfly Healthtech Pvt Ltd. R.Verma: Employee; Fitterfly Healthtech Pvt Ltd, Wellthy Therapeutics Pvt Ltd. S.S.Kulkarni: None. C.Selvan: None. A.D.Modi: None. M.T.Shenoy: None. A.L.Jain: None. R.Das: None.