Abstract 65: Better metabolic outcomes in people with diabetes mellitus on a personalized lifestyle care program

Background: The advent of digital Diabetes self-management education (DSME) has revolutionized the management of people with Diabetes Mellitus (PwD). “Impact Program” works on the same guiding principles. The program offers management of the lifestyle factors involved in diabetes, including guidance on the dietary choices, exercises, management of stress, adherence to the regimen, reminders for the tasks and self-help educational material, leading to a positive behavioral change in PwD Aim: To assess the effect of novel, personalized diabetes care program, OneCare “IMPACT” program, on metabolic outcomes among PwD. Materials and Methods: It was a 3-month pretest-posttest study in PwD enrolled in a 12-week virtual care program. The health coach remotely monitored patients through weekly scheduled calls to track progress. The patient's data, recorded by coach, including HbA1c, weight, medicines, program engagement was used for the analysis. Results: 128 patients with complete data were included for analysis. The mean age of the participants was 43.46 (13.2) years, 69% were male, duration of DM diagnosis was 1.8 (.06-30) years, baseline HbA1c (%) of 8.8 (5.6-16), weight (kgs) of 74 (40-169). Decline in HbA1c (%) was -2.03 (SD 2.1, p < .001) with large effect size (d = 0.9). 66% of enrolled participants achieved post-HbA1c <7%. The significant mean improvement in FBS and PPBS (mg/dl) was -57.9 (SD 72.7) and -84.3 (SD 104.1) respectively. Mean weight (kgs) change was -2.8 (SD 4.01, p < .001) with effect size (d = 0.69). 36% had a reduction in weight of 35%. 8% achieved reduction of 310 percent. There was a statistically significant reduction in BMI of -0.97 kg/m2, (p=<.001). A significant positive correlation (r = 0.3) was found between weight reduction and post intervention HbA1c (p = .02). The mean attendance and engagement correlated well with the outcomes. At the start of program, 54% were onsulfonylurea &/or Insulin and 28% were prescribed SGLT2 inhibitors/GLP1 (n = 98). Post-intervention medication data (n = 63) revealed 47% had reduction and 44% continued same dose of diabetic medication, with <10% needing an upward revision. Conclusion: Clinically meaningful metabolic outcomes were achieved through the program. Significant weight reduction despite majority of people on SU&/or Insulin highlights the importance of lifestyle care intervention. However, well designed RCTs in Indian context are required further to confirm the findings.