Combined improvement of insulin resistance and hypertension using whole body digital twin technology in diabetic hypertensives- a real world study

Abstract

Introduction: Insulin resistance is multifaceted phenomenon that affects blood pressure homeostasis Methods: 207 patients (163 male), with T2DM and concomitant hypertension were evaluated for impact of the Twin Precision Nutrition (TPN) Program, which utilises a whole-body digital twin technology, powered by artificial intelligence and Internet of Things. As part of the assessment, the change in, insulin resistance (HOMA2-IR) and systemic hypertension (Systolic BP, Diastolic BP), as measured by HBPM (Home Blood Pressure Monitoring) were evaluated longitudinally for three months. Student-t test and Pearson r was utilised for statistical analysis Results: 49.7% (n = 103) achieved HbA1c less than 7%, 37.1% (n = 77) achieved hypertension control (SBP < 130 mmHg, DBP <80 mmHg) and 20.2% (n = 42) achieved both hypertension and targeted glycemic control (SBP < 130 mmHg, DBP <80 mmHg, HbA1c <7%). Mean duration of diabetes was 8.9 years (±7.2, minimum 0, maximum 35, 95% CI 7.9 to 9.9). The reduction in the HbA1c (%), SBP (mmHg), DBP (mmHg) and HOMA2 IR was -1.8 ± 0.1, -10.67 ± 1.51, -6.28 ± 1.01 and -0.93 ± 0.16, was highly statistically significant, respectively (p < 0.0001) (Table). There was a positive correlation between insulin resistance (HOMA2-IR) and both SBP (r = 0.17, p = 0.0098) and DBP (r = 0.14, p = 0.0382). The association between the insulin resistance was relatively stronger for SBP than for DBP. Of initial 69 patients who had high HOMA2-IR (≥2.9) reduced to just 6 patients Conclusion: Our study is distinct to demonstrate the clinical utility of digital health intervention to utilise mutli-pronged approach provided by technology enabled precision nutrition, to address multiple pathways simultaneously. Our results provide insights into the acute benefits for hypertension and need corroboration with long term follow up to provide insights for end organ protection that directly mitigates the complications of diabetes and hypertension.