8814 Concordance in Defining Diabetes Remission: A Comparative Analysis of HbA1c, eA1c, and FPG Criteria After One Year of Digital Twin (DT) Intervention

Abstract Disclosure: P. Shamanna: None. M. Dharmalingam: None. A. Vadavi: None. A. Keshavamurthy: None. S. Bhonsley: None. M. Thajudeen: None. A. Balasubramanian: None. S.R. Joshi: None. Introduction: This study investigates the concordance among HbA1c, estimated A1c (eA1c), and fasting plasma glucose (FPG) remission criteria following one year of Digital Twin (DT) intervention. Understanding the agreement of these criteria in a cohort of 209 patients is critical for evaluating diabetes treatment efficacy. Methods: Diabetes remission was assessed in 209 patients after one year of DT intervention, using HbA1c, eA1c, and FPG criteria. Kappa values, along with sensitivity, specificity, and p-values, were calculated for concordance. Mean, standard deviation, and p-values for age, duration of diabetes, HbA1c, fasting plasma glucose, and eA1c were also computed. Results: The study revealed substantial agreement between HbA1c and eA1c criteria (Kappa: 0.751, indicating 'substantial' agreement), HbA1c and FPG criteria (Kappa: 0.703, indicating 'substantial' agreement), and eA1c and FPG criteria (Kappa: 0.719, indicating 'substantial' agreement), post one year of DT intervention. The average age of participants was 43.89 years (±8.72), with a diabetes duration of 3.65 years (±2.66). The initial HbA1c was 9.02% (±1.90), reducing to 6.00% (±0.67) at the end of the study. Initial and final fasting plasma glucose levels averaged 170.75 mg/dL (±61.11) and 109.33 mg/dL (±30.60), respectively. Remission rates were 72.73% for HbA1c, 75.60% for eA1c, and 71.29% for FPG. Conclusion: Our findings suggest that remission using either eA1c or FPG criteria can be reliably compared to the gold standard HbA1c criteria, with all showing 'substantial' agreement post one year of DT intervention. This high concordance, reflected in the statistically significant kappa values, highlights the effectiveness of eA1c and FPG criteria as robust tools in assessing diabetes remission alongside the HbA1c criteria. These insights are crucial for clinical practice and diabetes research, offering flexibility in evaluating patient outcomes. Presentation: 6/1/2024