A digital therapeutic effectively delivers lifestyle change for type II diabetes and prediabetes in primary care

Abstract Introduction The syndemic of diabesity is prevalent; and currently overconsumption is killing more people than starvation. Lifestyle change is a class I indication for the management of chronic diseases including cardiovascular disease and diabetes; but its implementation in primary care is fragmented. Purpose To determine if a digital therapeutic can positively affect type II diabetes and prediabetes in a primary care setting, in the NHS. Methods We used a large language model Artificial Intelligence in a closed evidenced-based format with cardiovascular and diabetes guidelines, to implement lifestyle change for patients in primary care, that melds seamlessly into the pathways of care of the primary care physician. Fig 1 The GDPR compliant digital therapeutic interacts with the primary care electronic health record to identify suitable patients for enrolment. Patients after informed consent on-board and are exposed to educational webinars at weeks 1, 3, 5, 9, 12, 26 and 52; via an application. Additional asynchronous advice from a lifestyle coach and nudge-psychology educational videos are continuously provided. We enrolled patients with non-insulin dependent type II diabetes and prediabetes and defined engaged patients as those who attended 4 or more webinars/consults after 28 days post-enrolment; versus those who did not (non-engaged). The effects on weight, BMI, HbA1c, total cholesterol and triglycerides were monitored after one year. Statistical analysis used student t-test of enrolled blood tests versus those at one year. Results Engagement was > 84% for patients with type II diabetes and > 75% for those with prediabetes. The effects of the digital therapeutic on engaged versus non-engaged patients for both type II diabetes and prediabetes is shown in Table 1. The average HbA1c for the engaged Type II Diabetes cohort (n=168) was 61.8 mmol/mol which declined through lifestyle to 51.7 mmol/mol (p