Level2’s virtual specialty clinic, offered across the United States to people with type 2 diabetes on participating insurance plans, includes continuous glucose monitors (CGM) , fitness trackers, lifestyle recommendations, and/or coach/clinician interactions. We retrospectively assessed differences in engagement and glycemic measures over 24 weeks following Level2 enrollment. From 01/01/21 to 07/31/21, 9,137 individuals newly joining Level2 had at least 12 prior months of continuous enrollment in a participating commercial health plan to assess demographics using medical and pharmacy claims. This group was 47% female, averaged 55 years of age (SD 9) , and averaged 0.7 (SD 1.1) Diabetes Complications and Severity Index conditions. Most (60%) had fill histories for 1 or 2 diabetes drug classes; 7% had four or more.Over 24 weeks, participants averaged 175 days of enrollment and coaching interactions; two in three (N = 5,760) wore a CGM at least once. We used least absolute shrinkage and election operator regression analysis, multivariable logistic regression analysis, and zero inflated negative binomial to find features associated with coaching visit frequency and CGM wear; associations included younger age and nephropathy-related claim history. For a subset with available A1c values in the 3 months before starting Level2 and sufficient CGM data at week 12 (N = 458) or week 24 (N = 512) , GMI-based glycemic improvement of 0.5% or greater was evident for 63 - 67% of those with initial A1c between 7 - 9% and 94 - 97% of those with an initial A1c above 9%. Over 24 weeks, Level2 engagement outcomes were associated with younger age and nephropathy-related claim history; improvements in glycemic control were evident at weeks 12 and 24, particularly for those entering Level2 with A1c above 9%. Additional research is needed to characterize longitudinal clinical and engagement outcomes, including features associated with achieving and sustaining type 2 diabetes remission.


S.Kamrudin: Employee; UnitedHealth Group. C.Clark: Employee; UnitedHealth Group, Stock/Shareholder; UnitedHealth Group. J.P.Mondejar: None. M.F.Vargas: None. N.Thompson: Employee; Level2. E.Macfarlane: Employee; Level2. A.Defail: Employee; Level2. A.L.Oechler: Employee; Level2. D.J.Cook: None.

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