Participation in a digital carbohydrate-reduced nutrition program was associated with a reduced risk of diabetic polyneuropathy (HR 0.54; 95% CI 0.36-0.82; p=0.004) compared to matched controls.
Cohort (n=9,000)
Does a digital carbohydrate-reduced nutrition program reduce incident diabetic neuropathy in adults with type 2 diabetes and/or obesity?
A digital carbohydrate-reduced nutrition program was associated with a significant reduction in the risk of incident diabetic polyneuropathy over 1.5 years in adults with type 2 diabetes and/or obesity.
Hazard Ratio: 0.84 (95% CI 0.68–1.04)
p-value: p=0.12
Introduction and Objective: Diabetic peripheral neuropathy is a common and disabling complication of type 2 diabetes with limited disease-modifying therapies. Management primarily focuses on glycemic control and symptomatic relief, underscoring the need for interventions that address underlying metabolic drivers and disease progression. Methods: Using Komodo Healthcare Map administrative claims, adults with established T2D and/or obesity participating in a digital carbohydrate-reduced nutrition program were matched 1:1 to comparators using propensity scores incorporating demographics, comorbidities, socioeconomic indicators, healthcare utilization, and baseline cardiometabolic medication classes, achieving good balance across covariates. The final matched cohort included 4,500 participants per group (N=9,000), with mean follow-up of approximately 1.5 years. Incident diabetic neuropathy (overall and subtypes: autonomic, focal, polyneuropathy, unspecified) was assessed using Cox proportional hazards models. Results: Program participation showed a nonsignificant trend toward reduced risk of any diabetic neuropathy (HR 0.84, 95% CI 0.68-1.04, p=0.12). Participation was associated with a statistically significant reduction in diabetic polyneuropathy (HR 0.54, 95% CI 0.36-0.82, p=0.004), the most clinically consequential subtype. At 1 year, cumulative incidence of polyneuropathy was 1.04% in comparators versus 0.56% in program participants, corresponding to an absolute risk reduction of 0.48% and a number needed to treat of 207. Associations for other neuropathy subtypes were not significant. Conclusion: These findings suggest that digitally delivered carbohydrate-reduced interventions may reduce the risk of diabetic polyneuropathy through improvements in glycemia, weight, and cardiometabolic risk factors, supporting longer-term evaluation. Disclosure S.J. Athinarayanan: Employee; Current; Virta Health Corp. Stock/Shareholder; Current; Virta Health Corp. C.G. Roberts: Employee; Current; Virta Health Corp. Stock/Shareholder; Current; Virta Health Corp. Advisory Panel; Current; Coalition for Metabolic Health.
ATHINARAYANAN et al. (Fri,) conducted a cohort in Type 2 diabetes and/or obesity (n=9,000). Digital carbohydrate-reduced nutrition program vs. Propensity-matched comparators was evaluated on Incident any diabetic neuropathy (HR 0.84, 95% CI 0.68-1.04, p=0.12). Participation in a digital carbohydrate-reduced nutrition program was associated with a reduced risk of diabetic polyneuropathy (HR 0.54; 95% CI 0.36-0.82; p=0.004) compared to matched controls.