612-P: Impact of Continuous Glucose Monitoring (CGM) vs. Blood Glucose Monitoring (BGM) on Dietary Adherence and Weight during a Medically Supervised Ketogenic Diet Program (MSKDP) in People with Type 2 Diabetes (T2D)

Introduction: Lifestyle-based interventions that promote nutritional ketosis can be effective for T2D management. This three-month trial compared use of CGM or BGM to support a MSKDP delivered via continuous remote care. Methods: In this randomized trial, CGM (N=81) or BGM (N=82) data were used by participants and the care team to support dietary adherence and medication management decisions. Differences in 90-day mean blood beta-hydroxybutyrate (BHB) levels and in changes in dietary intake and weight from baseline to three months (Base to M3) were assessed. This is a secondary and exploratory outcome analysis. Results: Participants in CGM and BGM arms were not different at baseline (Mean + SD): 53 + 10 years old; 10 + 8 years with T2D; HbA1c 8.1% + 1.2%; taking 2.2 + 1.0 diabetes medications. The 90-day mean BHB levels were 0.54 mmol/L for CGM and 0.48 mmol/L for BGM; p=0.24. Energy and carbohydrate intake decreased significantly (Base to M3), with no differences between arms. Weight change did not differ between arms. See Table 1. Mean 90-day BHB levels were negatively correlated with carbohydrate intake (r= -0.26; p=0.02) and weight change (r= -0.28; p=0.01) at M3. Conclusion: The MSKDP led to large decreases in energy and carbohydrate intake, and both CGM and BGM led to similar BHB levels and weight change. Disclosure H.J. Willis: Research Support; Abbott. Other Relationship; Abbott. Research Support; Academy of Nutrition and Dietetics, Dexcom, Inc. A.L. McKenzie: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. Employee; Abbott. C.G.P. Roberts: Other Relationship; Virta Health Corp. S.E. Asche: Stock/Shareholder; Gilead Sciences, Inc., AbbVie Inc., GlaxoSmithKline plc. S. Krizka: None. R.N. Adams: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. B.M. Volk: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. A.R. Zoller: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. S.J. Athinarayanan: Employee; Virta Health Corp. R.M. Bergenstal: Other Relationship; Abbott. Research Support; Arkray Marketing. Consultant; Ascensia Diabetes Care, Bigfoot Biomedical, Inc., CeQur. Other Relationship; Dexcom, Inc., Eli Lilly and Company. Consultant; embecta, Hygieia. Research Support; Insulet Corporation. Consultant; MannKind Corporation. Other Relationship; Medtronic, Novo Nordisk. Consultant; Onduo LLC, Roche Diabetes Care. Other Relationship; Sanofi. Research Support; Tandem Diabetes Care, Inc. Other Relationship; UnitedHealth Group. Consultant; Vertex Pharmaceuticals Incorporated, Zealand Pharma A/S. Funding Abbott Diabetes Care