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Baseline HbA1c is associated with glycemic response to digital personalized nutrition in type 2 diabetes: A
Indira Kaibagarova1, Aigul Sartayeva2, Nurgul Ablakimova1
1Department of Pharmacology, Clinical Pharmacology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
Background And Aims:
Digital personalized nutrition is increasingly implemented in type 2 diabetes care, but the therapeutic effects appear to be heterogeneous in real-world settings. The aims of this study were to evaluate variations in the glycemic response to a digital personalized dietary intervention and identify baseline determinants of treatment effectiveness.
Methods:
In this prospective real-world before-after study, 47 adult outpatients with type 2 diabetes received individualized dietary recommendations generated by a web-based platform, with unchanged pharmacotherapy. Glycated hemoglobin (HbA1c), dietary intake, and body mass index were assessed at baseline and after 2-3 months. Subgroup analyses were performed according to baseline HbA1c (<7.0% vs ≥ 7.0%).
Results:
The intervention was associated with significant reductions in energy intake and body mass index. The overall change in HbA1c at the population level was modest, but a pronounced and statistically significant reduction was observed in patients with baseline HbA1c ≥ 7.0% (p = 0.003), whereas no meaningful change occurred in patients with well-controlled baseline glycemia. Baseline HbA1c was associated with the magnitude of the glycemic response to the intervention.
Conclusions:
Digital personalized nutrition in routine clinical practice resulted in heterogeneous glycemic effects rather than a uniform population-level response. Clinically meaningful improvement was primarily observed in patients with elevated baseline HbA1c, supporting a targeted implementation strategy and highlighting the importance of patient stratification in digital dietary interventions.
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