Reply to: Concerns regarding interpretation and reporting in Kolivas et al. mHealth low carbohydrate dietary intervention in T2D

We provide a summary of clarifications to address issues identified in our article "mHealth low carbohydrate dietary intervention ameliorates glycaemic profile, blood pressure and weight status in people with type 2 diabetes 1 .We seek to rectify the comparison with the T2Diet study, to maintain scientific accuracy.In addition, clarifications of the secondary categorical analysis conducted with regards to (i) adherence and (ii) weight loss are presented.Critique: In contextualising the findings, the authors cite the T2Diet Study 2 , the only randomised controlled trial of a digital low carbohydrate dietary program for T2D conducted in Australia.They accurately reported the between-group differences of the 16-week intervention-HbA1c -0.6%, body weight -3.3 kg, BMI -1.1 kg/m, and reduced medication requirements-but then misrepresent these results as within-group changes, stating that "while the average reduction in HbA1c in the T2Diet study (-0.6%) was less than the improvement recorded in the current trial (-1.0%)" (p. 6).This comparison understates the T2Diet findings and exaggerates the effect of the current intervention.In fact, the T2Diet within-group changes were HbA1c -0.94%, weight -4.36 kg, and BMI -1.48 kg/m-all statistically significant.Distinguishing between-group differences from within-group changes is essential for fair comparison and accurate scientific and clinical interpretation 3,4 .Being a single-arm trial reporting within-group changes, the manuscript should clearly reflect this distinction to prevent misrepresentation of relative intervention effects.Response: Regarding the comparison of the primary outcome HbA1c with the T2Diet study, we acknowledge that our original statement may have inadvertently emphasised between-group differences rather than within-group changes.This statement was unintentional, and the information erroneously misinterpreted the between-group and within-group differences.We would like to thank you for highlighting this and agree that a clearer and more accurate representation would enhance the integrity of our manuscript.Upon revisiting the T2Diet publication, we confirm that the within-group reductions reported for the intervention group were indeed 0.94% for HbA1c, 4.36 kg for body weight, and 1.48 kg/m for BMI, all statistically significant.We therefore propose the following minor correction to the relevant statement in our discussion section: