SAT-538 Improvement In Glycemic Control And Cardiometabolic Parameters With Digital Twin Technology: Outcomes Of RCT At 2 Years

Abstract Disclosure: S.R. Joshi: Novo Nordisk, Twin Health, USV, Zydus Lifesciences, Franco Indian, Glenmark, Marico, Sanofi, Abbott Laboratories, Eli Lilly & Company, Lupin, Bayer Zydus, Alkem, Alembic, DRL, Meyer Organics, Universal Nutrisciences. M. Dharmalingam: Twin Health. A. Vadavi: Twin Health. A. Keshavamurthy: Twin Health. D. Shamanna: Twin Health. L. Shah: Twin Health. M. Thajudeen: Twin Health. M. Mohamed: Twin Health. Introduction: We evaluated the effectiveness of a Digital Twin (DT) intervention versus standard care (SC) in improving glycemic and cardiometabolic parameters over two years (2 y) among Type 2 diabetes (T2D) participants. The DT platform leverages AI and the Internet of Things to integrate multi-dimensional data, delivering personalized precision nutrition and health recommendations via a mobile app. Methods: We conducted a prospective randomized trial comparing changes in HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), HDL-C, and triglycerides (TGs) in the DT intervention group (T) (n=209) and SC control group (C) (n=84). The DT integrates clinical and sensor data using machine learning to predict personal glucose response, leveraging continuous glucose monitoring (CGM) and self-recorded dietary intake via a mobile app. Results: The mean age was 46 years (±9.8, 95% CI 45 to 47). HbA1c (%) in T reduced by -2.5 (±1.8, 95% CI -2.8 to -2.3) from 9% to 6.5% (p<0.0001), as compared to C by -0.2 (±1.5, 95% CI -0.6 to 0.1) from 8.5% to 8.2% (p=0.1843, ns). SBP (mmHg) in T decreased by -5.4 (±12.3, 95% CI -7.1 to -3.8) from 127.5 to 122.0 (p<0.0001), as compared to C by -4.3 (±16.2, 95% CI -7.8 to -0.8) from 134.1 to 129.8 (p=0.0161). DBP (mmHg) in T decreased by -3.5 (±9.8, 95% CI -4.8 to -2.2) from 84.9 to 81.4 (p<0.0001), as compared to C by -2.0 (±10.0, 95% CI -4.2 to 0.2) from 87.3 to 85.3 (p=0.0716, ns). WC (cm) in T decreased by -9.4 (±10.7, 95% CI -10.9 to -8.0) from 97.6 to 88.2 (p<0.0001) compared to C, which increased by 0.3 (±6.9, 95% CI -1.2 to 1.8), from 95.3 to 95.6 (p=0.6740, ns). HDL-C (mg/dL) in T increased by 7.6 (±7.1, 95% CI 6.6 to 8.5) from 34.9 to 42.5 (p<0.0001) compared to C, which showed a non-significant change of 0.4 (±25.6, 95% CI -5.2 to 6.0) from 39.5 to 39.9 (p=0.8886, ns). TGs (mg/dL) in T decreased by -46.2 (±180.2, 95% CI -70.7 to -21.6) from 221.2 to 175.0 (p<0.0001), whereas C showed a non-significant reduction of -36.0 (±143.8, 95% CI -67.2 to 4.7) from 253.0 to 217.0 (p=0.1960, ns). Conclusion: The DT intervention led to significant improvements in glycemic control, adiposity measures, lipid profile, and blood pressure compared to SC, suggesting its potential as an effective, personalized approach for managing T2D and related cardiometabolic risk factors. Presentation: Saturday, July 12, 2025