2776-LB: Real-World Wearable-Driven Insights Practiced within a Continuous Hybrid Care Model among Individuals with Diabetes and Prediabetes: A Three-Month Observational Study

Introduction and Objective: Wearable devices continuously track sleep, stress, and physical activity, revealing the interaction between lifestyle behaviors and cardiometabolic outcomes. This study aimed to assess the association between wearable-measured lifestyle behaviors and changes in glycemic and weight control among adults with diabetes and prediabetes in a hybrid care model over three months. Methods: In this retrospective study at GluCare.Health, 104 adults with diabetes (n=91) and prediabetes (n=13) were monitored using ŌURA rings and CGM. Daily steps, sleep, stress, and GMI were recorded alongside demographics, anthropometry, and metabolic profiles. Associations between sleep, stress, PA and change in HbA1c and weight were assessed using multiple linear regression adjusted for age, sex and BMI stratified by diagnosis. Results: Participants had a mean age of 47.5 ± 8.9 years; males predominated (diabetes 76.9%, prediabetes 69.2%). Over three months, 31.9% of diabetes and 53.8% of prediabetes participants achieved >7,000 steps/day. Time-in-Range improved from 86.3% to 89.4%. Higher sleep variability was significantly associated with weight gain (β=1.38, 95% CI: 0.18-2.58, p=0.025). Although not-significant, greater HbA1c reductions were observed with PA (β:-0.24, 95% CI:-0.70,0.22, p=0.302) adjusted for age, sex and BMI. Higher stress attenuated HbA1c and weight change across the groups non-significantly (p>0.05). Conclusion: Integration of wearables and CGM in a real-world setting demonstrated improvements in glycemic control and revealed that stress and sleep variability hinder progress. These findings underscore the importance of lifestyle behaviors, beyond pharmacotherapy, in diabetes and prediabetes management.