Reducing HbA1c in Type 2 Diabetes Using Digital Twin Technology-Enabled Precision Nutrition: A Retrospective Analysis

Shamanna, Paramesh; Saboo, Banshi; Damodharan, Suresh; Mohammed, Jahangir; Mohamed, Maluk; Poon, Terrence; Kleinman, Nathan L.; Thajudeen, Mohamed

doi:10.1007/s13300-020-00931-w

Cited by 72 publications

(59 citation statements)

References 28 publications

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“…In a study of 549 patients with type 2 diabetes taking insulin or oral hypoglycemic medications, McCall et al found that mean daily LBGI and HBGI values over weeks 8 to 26 of the study were approximately 0.5 (minimal range) and 5.5 (moderate range), respectively 15 . In the present study, mean LBGI and HBGI over days 1 to 90 were 1.37 (low range) and 2.13 (low range), respectively, and most patients were able to eliminate hypoglycemic medication use over that time 26 . As reported previously, all 12 patients who had been taking insulin were able to discontinue its use, two-thirds of the patients on metformin discontinued taking metformin, and almost every patient on other oral hypoglycemic medications was able to stop taking them 26 .…”

Section: Discussionsupporting

confidence: 43%

“…In the present study, mean LBGI and HBGI over days 1 to 90 were 1.37 (low range) and 2.13 (low range), respectively, and most patients were able to eliminate hypoglycemic medication use over that time 26 . As reported previously, all 12 patients who had been taking insulin were able to discontinue its use, two-thirds of the patients on metformin discontinued taking metformin, and almost every patient on other oral hypoglycemic medications was able to stop taking them 26 . Other metrics for this population, such as HbA1c, fasting glucose, time in range, and weight, were reported previously 26 .…”

Section: Discussionsupporting

confidence: 43%

“…Improvements over the 90 days were also seen in BMI (6.2% reduction, p < 0.0001). BMI reductions may have stemmed from the nutritional interventions, increases in physical activity (mean (SD) steps taken per day increased from 4677.4 (2804.9) at baseline to 7004.1 (3999.0) at 90 days) 26 , the 63% reduction in fasting insulin level, and the reduction in average homeostatic model assessment of insulin resistance (HOMA-IR) from 7.4 (3.5) at baseline to 3.1 (2.5) at 30 days and 3.2 (2.8) at 90 days 26 . Additionally, the percent of patients taking antihypertensive medications decreased from 35.9 to 4.7% (p < 0.0001).…”

Section: Discussionmentioning

confidence: 99%

“…The model provides precision nutrition guidance each day to the patient. Some results from the TPT Program have been reported previously 26 . In 64 patients with type 2 diabetes who enrolled and adhered to the TPT Program, mean (standard deviation) HbA1c decreased from 8.8% (2.2%) at baseline to 7.7% (1.6%) after 30 days and 6.9% (1.1%) after 60 and 90 days (all p < 0.0001 vs. baseline).…”

Section: Introductionmentioning

confidence: 95%

“…The patients also had a significant decrease in insulin resistance and a significant increase in number of steps taken per day. Most patients were able to stop taking hypoglycemic medications 26 .…”

Section: Introductionmentioning

confidence: 99%

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Retrospective study of glycemic variability, BMI, and blood pressure in diabetes patients in the Digital Twin Precision Treatment Program

Shamanna¹,

Dharmalingam

Sahay

et al. 2021

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The objective of this retrospective observational cohort study was to measure glycemic variability and reductions in body mass index (BMI), blood pressure (BP), and use of antihypertensive medications in type 2 diabetes (T2D) patients participating in the digital twin-enabled Twin Precision Treatment (TPT) Program. Study participants included 19 females and 45 males with T2D who chose to participate in the TPT Program and adhered to program protocols. Nine additional enrollees were excluded due to major program non-adherence. Enrollees were required to have adequate hepatic and renal function, no myocardial infarction, stroke, or angina ≤ 90 days before enrollment, and no history of ketoacidosis or major psychiatric disorders. The TPT program uses Digital Twin technology, machine learning algorithms, and precision nutrition to aid treatment of patients with T2D. Each study participant had ≥ 3 months of follow-up. Outcome measures included glucose percentage coefficient of variation (%CV), low blood glucose index (LBGI), high blood glucose index (HBGI), systolic and diastolic BP, number of antihypertensive medications, and BMI. Sixty-four patients participated in the program. Mean (± standard deviation) %CV, LBGI, and HBGI values were low (17.34 ± 4.35, 1.37 ± 1.37, and 2.13 ± 2.79, respectively) throughout the 90-day program. BMI decreased from 29.23 ± 5.83 at baseline to 27.43 ± 5.25 kg/m2. Systolic BP fell from 134.72 ± 17.73 to 124.58 ± 11.62 mm Hg. Diastolic BP decreased from 83.95 ± 10.20 to 80.33 ± 7.04 mm Hg. The percent of patients taking antihypertensive medications decreased from 35.9% at baseline to 4.7% at 90 days. During 90 days of the TPT Program, patients achieved low glycemic variability and significant reductions in BMI and BP. Antihypertensive medication use was eliminated in nearly all patients. Future research will focus on randomized case–control comparisons.

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Section: Discussionsupporting

confidence: 43%