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

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 m...

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Autores principales:	Paramesh Shamanna, Shashank Joshi, Lisa Shah, Mala Dharmalingam, Banshi Saboo, Jahangir Mohammed, Maluk Mohamed, Terrence Poon, Nathan Kleinman, Mohamed Thajudeen, Ashok Keshavamurthy
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Type 2 diabetes Diabetes reversal Precision nutrition Artificial intelligence Diabetes medication elimination Digital twin technology Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/b498885d7d104b639d841041d88afbd9
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spelling	oai:doaj.org-article:b498885d7d104b639d841041d88afbd92021-11-21T12:29:46ZType 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study10.1186/s40842-021-00134-72055-8260https://doaj.org/article/b498885d7d104b639d841041d88afbd92021-11-01T00:00:00Zhttps://doi.org/10.1186/s40842-021-00134-7https://doaj.org/toc/2055-8260Abstract 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.Paramesh ShamannaShashank JoshiLisa ShahMala DharmalingamBanshi SabooJahangir MohammedMaluk MohamedTerrence PoonNathan KleinmanMohamed ThajudeenAshok KeshavamurthyBMCarticleType 2 diabetesDiabetes reversalPrecision nutritionArtificial intelligenceDiabetes medication eliminationDigital twin technologyDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENClinical Diabetes and Endocrinology, Vol 7, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Type 2 diabetes Diabetes reversal Precision nutrition Artificial intelligence Diabetes medication elimination Digital twin technology Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	Type 2 diabetes Diabetes reversal Precision nutrition Artificial intelligence Diabetes medication elimination Digital twin technology Diseases of the endocrine glands. Clinical endocrinology RC648-665 Paramesh Shamanna Shashank Joshi Lisa Shah Mala Dharmalingam Banshi Saboo Jahangir Mohammed Maluk Mohamed Terrence Poon Nathan Kleinman Mohamed Thajudeen Ashok Keshavamurthy Type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study
description	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.
format	article
author	Paramesh Shamanna Shashank Joshi Lisa Shah Mala Dharmalingam Banshi Saboo Jahangir Mohammed Maluk Mohamed Terrence Poon Nathan Kleinman Mohamed Thajudeen Ashok Keshavamurthy
author_facet	Paramesh Shamanna Shashank Joshi Lisa Shah Mala Dharmalingam Banshi Saboo Jahangir Mohammed Maluk Mohamed Terrence Poon Nathan Kleinman Mohamed Thajudeen Ashok Keshavamurthy
author_sort	Paramesh Shamanna
title	Type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study
title_short	Type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study
title_full	Type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study
title_fullStr	Type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study
title_full_unstemmed	Type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study
title_sort	type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b498885d7d104b639d841041d88afbd9
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Type 2 diabetes reversal with digital twin technology-enabled precision nutrition and staging of reversal: a retrospective cohort study

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