1054-OR: Mitraa-T1D: A Multicenter Randomized Trial of a Digital Conversational Support Tool in Adults with Type 1 Diabetes

Introduction and Objective: Adults with type 1 diabetes carry a high daily self-management burden related to insulin dosing and glucose monitoring, often contributing to diabetes distress and suboptimal glycemic control. This study aimed to determine whether use of a digital conversational support tool, as an adjunct to usual care, improves glycemic and behavioral outcomes compared with usual care alone in adults with type 1 diabetes. Methods: This 6-month, multicenter, parallel-group randomized controlled trial enrolled 308 adults with type 1 diabetes (HbA1c ≥7.0%), randomized 1:1 to digital conversational support plus usual care or usual care alone. Exclusion criteria included pregnancy, recent diabetic ketoacidosis or severe hypoglycemia, severe cognitive impairment, or advanced renal disease. Self-care behaviors were assessed using the Summary of Diabetes Self-Care Activities (SDSCA), and diabetes distress using the Diabetes Distress Scale (DDS-17). The primary endpoint was change in HbA1c. Secondary outcomes included self-monitoring of blood glucose (SMBG) and physical activity. Results: HbA1c data were available for 292 participants (94.8%). Mean age was 30.2 ± 9.6 years. Mean HbA1c decreased from 8.2 ± 1.0% to 7.5 ± 0.9% in the intervention group compared with 8.1 ± 1.1% to 7.9 ± 1.0% with usual care, yielding a between-group difference of −0.5% (p0.001). SDSCA scores improved more in the intervention group (+1.3 vs +0.4; p0.001). DDS-17 scores declined by −0.8 versus −0.3 (p0.001). Median SMBG frequency increased from 4 to 7 checks/day versus 4 to 5 checks/day. Conclusion: In this multicenter randomized trial, adjunctive use of a digital conversational support tool was associated with improved glycemic control, self-care behaviors, and reduced diabetes distress in adults with type 1 diabetes. Disclosure B. Saboo: None. S. Saboo: None. A. Modi: None. H. Hirani: None. S. Samajdar: None.