Type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study

Clinical Diabetes and Endocrinology

Mala Dharmalingam¹  Banshi Saboo²  Nathan Kleinman³  Jahangir Mohammed⁴  Mohamed Thajudeen⁴  Lisa Shah⁴  Shashank Joshi⁴  Maluk Mohamed⁴  Ashok Keshavamurthy⁴  Terrence Poon⁴  Paramesh Shamanna⁵ 

[1] Bangalore Endocrinology & Diabetes Research Centre;Diacare – Diabetes Care & Hormone Clinic;Kleinman Analytic Solutions, LLC;Twin Health, Mountain View;Twin Health;

关键词: Type 2 diabetes;    Diabetes reversal;    Precision nutrition;    Artificial intelligence;    Diabetes medication elimination;    Digital twin technology;   

DOI  :  10.1186/s40842-021-00134-7

来源: DOAJ

【 摘 要 】

Abstract Background Type 2 diabetes reversal has been viewed in the literature primarily as a dichotomous event (reversed or not reversed), even though this viewpoint may not be optimal for clinicians or patients. This cohort study’s objectives were to define stages of type 2 diabetes reversal and measure changes in reversal stages before and after 90 days of digital twin-enabled precision nutrition therapy. Methods This study defines seven stages of diabetes reversal. The study is a retrospective pre/post comparison of changes in reversal stage, hemoglobin A1c (HbA1c), weight, body mass index (BMI), and other metrics measured before and after precision nutrition therapy. Reversal stages were defined as Stage 0: HbA1c < 5.7% without medication for > 1 year, Stage 1: HbA1c < 5.7% without medication for < 1 year, Stage 2: HbA1c < 6.5% without medication, Stage 3: estimated HbA1c (eA1c) between 5.7 and 6.4% without medication, Stage 4: estimated HbA1c (eA1c) between 5.7 and 6.4% with metformin monotherapy, Stage 5: dual oral therapy, Stage 6: > = 3 medications. Results Reversal stage information was available for 463 patients at baseline and 90 days. At baseline, the proportions of patients in each reversal stage were Stages 1 and 2: 0%, Stage 3: 1%, Stage 4: 8%, Stage 5: 6%, and Stage 6: 85%. After 90 days, the proportions in each reversal stage were Stage 1: 2%, Stage 2: 9%, Stage 3: 32%, Stage 4: 39%, Stage 5: 7%, and Stage 6: 11%, indicating significant progress. Reversal stage progression rates varied by patient subgroup. Conclusions Type 2 diabetes patients reached differing reversal stages during 90 days of precision nutrition therapy. Use of reversal stages may benefit patients during therapy. Trial registration This was a retrospective study that was approved by the Medisys Clinisearch Ethical Review Board (without registration number) in 2019.

【 授权许可】

Unknown