OR20-07 Digital Twin Technology For T2D Remission And ASCVD Risk Reduction: 2-Year RCT Outcomes

Abstract Disclosure: S.R. Joshi: Novo Nordisk, USV, Twin Health, Zydus Lifesciences, Franco Indian, Glenmark, Marico, Abbott Laboratories, Sanofi, 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 compared the effectiveness of a Digital Twin (DT) intervention versus standard care in achieving sustained Type 2 diabetes (T2D) remission and reducing ASCVD risk score over two years (2 y). DT platform leveraging AI and the Internet of Things to integrate multi-dimensional data for personalized precision nutrition and health recommendations via a mobile app. Methods: We conducted a prospective randomized trial to compare the changes in theASCVD risk score in the DT intervention group (T) (n=209) as compared to the standard of care control group (C) (n=84). T2D remission was defined as A1C levels less than 6.5% without glucose-lowering medication for over 3 months. 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). In T group, 67.0% (140/209) sustained remission in two years compared to none in C group. The T group demonstrated a marked shift towards a lower ASCVD risk profile at 2 y, with 68.9% (n=144) of participants categorized as Low Risk compared to 49.3% (n=103) at baseline. While the C group remained unchanged at 42.9% (n=36). High-risk category reductions were more pronounced in the T group, decreasing to 0.9% (n=2) from 8.1% (n=17), while the C group increased to 18.9% (n=14) from 17.6% (n=13). In T group, mean ASCVD risk score (%), at baseline was 7.9 (±7.9, 95% CI 6.8 to 9.0), which decreased to 4.3 (±4.1, 95% CI 3.7 to 4.9), p<0.0001. In C group, mean ASCVD risk score (%), at baseline was 10.5 (±10.1, 95% CI 8.3 to 12.7), which changed to 10 (±9.7, 95% CI 7.9 to 12.1), p=0.3297 (ns). Conclusion: Digital Twin intervention significantly outperformed standard care, achieving sustained T2D remission and reducing ASCVD risk score over two years. DT approach led to a substantial shift towards a lower ASCVD risk profile, highlighting its potential as an effective personalized management for T2D remission and cardiovascular risk reduction. Presentation: Sunday, July 13, 2025