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AimsTelehealth became a patient necessity during the COVID pandemic and evolved into a patient preference in the post‐COVID era. This study compared the % total body weight loss (%TBWL), HbA1c reduction, and resource utilization among patients with obesity and diabetes who participated in lifestyle interventions with or without telehealth.MethodsA total of 150 patients with obesity and diabetes who were followed every 4–6 weeks either in‐person (n = 83) or via telehealth (n = 67), were included. All patients were provided with an individualized nutritional plan that included a weight‐based daily protein intake from protein supplements and food, an activity/sleep schedule‐based meal times, and an aerobic exercise goal of a 2000‐calorie burn/week, customized to patient's preferences, physical abilities, and comorbidities. The goal was to lose 10%TBWL. Telehealth‐based follow‐up required transmission via texting of weekly body composition measurements and any blood glucose levels below 100 mg/dl for medication adjustments. Weight, BMI, %TBWL, HbA1c (%), and medication effect score (MES) were compared. Patient no‐show rates, number of visits, program duration, and drop‐out rate were used to assess resource utilization based on cumulative staff and provider time spent (CSPTS), provider lost time (PLT) and patient spent time (PST).ResultsMean age was 47.2 ± 10.6 years and 74.6% were women. Mean Body Mass Index (BMI) decreased from 44.1 ± 7.7–39.7 ± 6.7 kg/m2 (p < 0.0001). Mean program duration was 189.4 ± 169.3 days. An HbA1c% unit decline of 1.3 ± 1.5 was achieved with a 10.1 ± 5.1%TBWL. Diabetes was cured in 16% (24/150) of patients. %TBWL was similar in regards to telehealth or in‐person appointments (10.6% ± 5.1 vs. 9.6% ± 4.9, p = 0.14). Age, initial BMI, MES, %TBWL, and baseline HbA1c had a significant independent effect on HbA1c reduction (p < 0.0001). Program duration was longer for in‐person follow‐up (213.8 ± 194 vs. 159.3 ± 127, p = 0.019). The mean annual telehealth and in‐person no‐show rates were 2.7% and 11.2%, respectively (p < 0.0001). Mean number of visits (5.7 ± 3.0 vs. 8.6 ± 5.1) and drop‐out rates (16.49% vs. 25.83%) were lower in telehealth group (p < 0.0001). The CSPTS (440.4 ± 267.5 min vs. 200.6 ± 110.8 min), PLT (28.9 ± 17.5 min vs. 3.1 ± 1.6 min), and PST (1033 ± 628 min vs. 113.7 ± 61.4 min) were significantly longer (p < 0.0001) for the in‐person group.ConclusionsTelehealth offered comparable %TBWL and HbA1c decline as in‐person follow‐up, but with a shorter follow‐up, fewer appointments, and no‐shows. If improved resource utilization is validated by other studies, telehealth should become the standard of care for the management of obesity and diabetes.

BackgroundSLE is a disease which is easily missed in regular clinical practice. In developing countries due to lack of investigation modalities and rheumatologist, early identification of the diseases process is delayed. By the time the patient reaches a higher medical care centre there is a significant time loss and advancement of the disease. NLR, PLR, RDW and MPV can be calculated from a complete blood count which will be available at any grass route heath centre.ObjectivesTo identify Cost effective biomarkers in predicting SLE in developing countries. Focussing on markers - Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), MPV.MethodsThis is a retrospective hospital based observational study conducted screening patients admitted from January 2016- November 2018 in with a diagnosis of SLE. We identified 150 patients with SLE and their NLR, PLR, and MPV data were collected and were correlated with equal control group without SLEResultsWe found that NLR, PLR, and MPV were highly significant with a p-value of 0.001 to be used as bio marker and also when further analysis was done using ROC curve with an area under curve of 76%, 81% and 78% respectively when compared with the control group.ConclusionWe conclude that NLR,PLR,and MPV is cost-effective bio marker which costs (< 1 Euro) in predicting SLE and also play a great in monitoring following up referring patient to higher centre for biopsy at a golden period which will aid in early management which will limit the mortality and morbidity associated with the diseaseReferences[1] Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, Hu Z, Ling Y, Yang Z, Zhong R Neutrophil, to Lymphocyte ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. ModRhematol.2016;26(3):372-6. doi: 10.3109/14397595.2015.1091136. Epub 2016 Mar 4.[2] Wu Y1, Chen Y1, Yang X2, Chen L1, Yang Y3 Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus.Int Immunopharmacol. 2016 Jul;36:94-99. doi: 10.1016/j.intimp.2016.04.006. Epub 2016 Apr 22.[3] Soliman WM1, Sherif NM1, Ghanima IM1, El-Badawy MA2. Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios in Systemic Lupus Erythematosus: Relation With Disease Activity and Lupus Nephritis. [4] Reumatol Clin. 2018 Aug 27. pii: S1699-258X(18)30167-0. doi: 10.1016/j.reuma.2018.07.008. [Epub ahead of print]Disclosure of InterestsNone declared