1007-P: Improvements in Glycemic Outcomes among Level2 Members Are Sustained after 24 Months

Background: Level2’s virtual specialty clinic, offered across the United States to people with type 2 diabetes on participating insurance plans, combines providers, coaches, continuous glucose monitors (CGM), and fitness trackers to help members gain insight, and focus on long-term behavior change. We retrospectively assessed differences in glycemic outcomes following one and two years of participation in Level2.

Methods: People joining Level2 between 01/01/21 and 07/31/21 who wore a CGM and had enrollment in a participating commercial health plan 24 months after and for at least 6 months prior to joining were included in the analysis. We used CGM-derived GMI (with ≥ 90% data sufficiency over 14 days) and A1c values available from a database of de-identified administrative claims to determine baseline, 12-month, and 24-month follow-up glycemic outcomes. Student t-tests were used to test for pair-wise differences in glycemic measures between baseline and follow-up periods overall and stratified by baseline A1c.

Results: Of the 2,035 people identified for the 2-year analysis, a subset (N = 161) had baseline A1c > 7.0% and valid GMIs during both follow-up periods. This subset was 48% (N = 78) male with mean age of 54.0 (SD = 8.4) years and had mean baseline A1c of 8.77% (SD = 1.38). The mean differences from baseline A1c to 12- and 24-month GMI were -1.39% (p < 0.001) and -1.36% (p < 0.001), respectively. The mean change from 12- to 24-month GMI (0.02%, p = 0.70) was not statistically significant. After 12 months, 38.5% achieved a target GMI ≤ 7% and 60% of these people continued to achieve this target after 24 months. In those with baseline A1c ≤ 9.0%, 58% had improved by more than 0.5% at 12 months and 80% maintained this reduction at 24 months. In those with A1c > 9.0%, 97% improved by more than 0.5% at 12 months and 95% maintained this reduction at 24 months.

Conclusion: Level2 members with baseline A1c and follow-up GMIs saw significant and sustained improvements in glycemic control after one and two years of engagement.