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Lifestyle is a Class I therapy for Managing Chronic Cardiovascular Diseases such as Type 2 Diabetes (T2D) and Non-Diabetic Hyperglycaemia (NDH). This study evaluates the effectiveness of a lifestyle digital therapeutic in three NHS Primary Care Networks (PCNs), to patients with T2D and NDH.Methods The intervention used an integrated neighbourhood delivery model. Patient identification was conducted via EMIS searches. A structured patient communication strategy was developed to support activation ( figure 1). Respondents underwent an initial onboarding consultation and gained access to an AI-driven suite of video-based education. Patients chose their health goals, to address chronic conditions such as MAFLD, obesity, PCOS, dyslipidaemia, and hypertension. Weekly SMS communications encouraged patients to participate. ‘Engaged Patients’ were those who attended 4 or more sessions. The service fits within usual care with no extra workload from clinicians. Clinical outcomes, including HbA1c and Weight were recorded.Findings T2D (n=1860) were offered the intervention, 260 (14%) enrolled. NDH (n=1110), 195 (17.6%) of these enrolled. At 52 weeks in 199 patients with TD2 , the engaged patients n=169(79%) showed a mean HbA1c reduction of 10.15 mmol/mol (–16.1%) a mean weight loss of 4.7 kg (–4.8.3%) and 64 (38%) HbA1c was below the 48 mmol/mol threshold for T2D; ( table 1) From NDH 114 patients: The engaged patients n= 86(75%) showed a mean HbA1c reduction of 2.06 mmol/mol (–4.7%) and a mean weight loss of 5.24kg (5.1%). 51(59%) HbA1c levels were below the 42 mmol/mol threshold for NDH.Interpretation This study demonstrates that Type 2 Diabetes and NDH treatment and prevention programmes can be delivered at scale and cost-effectively in primary care. Over a three-year period, this approach could potentially on-board 50–60% of primary care T2D or NDH populations into treatment, with c. 75% achieving clinically significant outcomes.Abstract 45 Table 1HbA1c ranges and movementsAbstract 45 Figure 1Patient communication, on-boarding and treatment delivery schematicThe following is a summary of patient activation into treatment