2783-LB: The Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study: A Six-Month, Fully Remote, Randomized Clinical Trial Evaluating Personalized Dietary Management in Individuals with Type 2 Diabetes

Introduction and Objective: Dietary recommendations for type 2 diabetes (T2D) aim to minimize postprandial glycemic response (PPGR), yet the optimal strategy remains unclear. The impact of precision nutrition on glycemic control is also not well established. Methods: The Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study was a fully remote, 6-month, 3-arm randomized controlled trial in U.S. adults (21-80 years) with moderately controlled T2D (HbA1c 6.5-8.0%). Participants were randomized to: (1) usual care control (UCC), (2) a Standardized intervention, or (3) a Personalized intervention. The Standardized arm received 14 behavioral counseling sessions focused on Mediterranean diet-based diabetes self-management; the Personalized arm received all Standardized components plus real-time, algorithm-driven feedback on predicted PPGR. Participants wore a continuous glucose monitor at baseline, 3, and 6 months to assess glycemic variability (GV) metrics, including mean amplitude of glycemic excursions (MAGE). Linear mixed models were used to compare changes in GV between arms. Results: Participants (n=161; UCC: n=59; Standardized: n=61; Personalized: n=41) were 60±12 years, 62.7% female, 46.6% White, 80.7% non-Hispanic; HbA1c was 6.77%±0.6%. The change in MAGE did not differ significantly between UCC and Standardized (p=0.24), UCC and Personalized (p=0.13), or Standardized and Personalized (p=0.70). Changes in other GV metrics were also not significantly different among the arms at 3 and 6 months. At 6 months, the Personalized arm showed a greater reduction in the coefficient of variation (CV) compared with UCC (mean difference: −1.84%; 95% CI: −3.57 to −0.11; p=0.04). Conclusion: In adults with moderately controlled T2D, a precision nutrition intervention using real-time, algorithm-driven PPGR feedback did not improve MAGE or most GV indices beyond usual care or Mediterranean diet-based counseling. Disclosure L. Berube: None. C. Wang: None. M. Curran: None. M. Pompeii: None. C. Thao: None. E.P. Ribeiro: None. S. Barua: None. L. Hu: None. H. Li: None. D.E. St-Jules: None. E. Segal: None. M. Bergman: Advisory Panel; Ended; Novo Nordisk. Advisory Panel; Current; Abbott. C. Popp: Consultant; Current; Longevix. Funding National Institutes of Health (R01NR018916)