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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.

Dulaglutide-based therapy may potentiate improved glycemic variability (GV) in patients with type 2 diabetes (T2D) owing to their several pancreatic and extra-pancreatic effects. This study assessed the effects of dulaglutide on GV using continuous glucose monitoring system (CGMS) in patients with T2D. Patients (N = 27) from a CGMS specialty center in India received dulaglutide as add-on to oral antidiabetics (OADs) with or without insulin and were subsequently monitored for continuous glucose data using CGMS (FreeStyle Libre Pro) for ≤15 days considering 70-140 mg/dL as target. CGMS data revealed a significant reduction (P<.05) in overall within-patient mean CGM glucose on Day 5 relative to Day 1 which further reduced at Day 15 (Figure), warranting titration of doses of OADs and/or insulin. Interestingly, the coefficient of variation for overall within-patient mean glucose on Day 15 (21.99%) was less compared to Day 1 (31.56%). Through Day 1 to Day 15, overall within-patient mean % time of glucose in target significantly (P<.05) increased (25.19% to 66.42%) along with reduced mean % time above target (68.96% to 17.42%). A non-significant increase in overall mean % time below target (5.86% to 16.16%) was observed with no events of severe hypoglycemia. Dulaglutide improved GV and is well tolerated in patients with T2D. Disclosure S.A. Patange: None.

Diabetic Kidney disease is strongly associated with cardiovascular events, premature mortality and ESRD. Gemigliptin can be used without dose adjustment in patients with renal failure. The current study aimed to assess the possible renoprotective effects of gemigliptin, using albuminuria and eGFR as indicators. This was a multi-center real-world retrospective analysis of 146 DPP-4 inhibitor naïve type 2 diabetic patients with established moderate DKD (eGFR between 30 to 45ml/min/1.73m2 over last 3 months) with diabetic retinopathy who received gemigliptin 50 mg once daily for 24 weeks in addition to anti-hyperglycemic, anti-hypertensives and statins. Goodness of fit was examined using SPSS statistics 20 and ANOVA was conducted to interpret the results. Baseline characteristics were: 71(48.6%) males and 75 (51.4%) females, the mean age was 60.81 ± 7.42 years, mean duration was 11.92 ± 3.3 years, mean BMI was 26.54 ± 2.59kg/m2. Gemigliptin showed significant improvements in glycaemia, renal and lipid parameters with no deterioration in retinopathy, liver enzymes and with no hypoglycemic episodes and was weight neutral. In the present study, gemigliptin reduced albuminuria independent of age, gender, duration of diabetes, Hba1c, eGFR and SBP. It could ameliorate diabetic nephropathy by reducing urine albumin excretion and mitigating the reduction of eGFR in diabetic patients. Mean changes in various efficacy parameters at week 24 of the overall study periodParametersAt Baseline (n=146)At 6 months (n=146)% change from Baseline to 6 monthsP valueFBS192.90 ± 52.64129.99 ± 19.4632.6Significant (<0.001)PPBS248.72 ± 62.75170.55 ± 23.0031.4Significant (<0.001)HbA1c9.22 ± 1.517.68 ± 0.571.5Significant (<0.001)UACR306.61 ± 77.17228.36 ± 45.8525Significant (<0.001)Albuminuria521.2 ± 62.2342.4 ± 51.334.2Significant (<0.001)eGFR37.37 ± 5.8641.76 ± 5.5212Significant (<0.001)Serum Creatinine1.70 ± 0.231.55 ± 0.218.8Significant (<0.001) Disclosure K. Shah: None. S.A. Patange: None. A.P. Gandhi: None.