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Artificial Intelligence‑Led Program Prevents Diabetes as Well as Human Coaches

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Original Article: https://www.medscape.com/viewarticle/ai-directed-diabetes-prevention-program-effective-human-2025a1000xam

The Study

Researchers wanted to find out if a diabetes‑prevention program run entirely by artificial intelligence (AI) could work as well as traditional programs led by human coaches. The goal was to help people with prediabetes — meaning those with high blood sugar but not yet diabetes — lower their risk through lifestyle changes focusing on healthy food choices, physical activity, and weight loss.

In a clinical trial, 368 adults with prediabetes and overweight or obesity were randomly assigned to one of two 12‑month programs. One group used a mobile app powered by a “reinforcement‑learning” AI, which provided nudges for diet, exercise, and weight tracking. The other group joined a human‑led version of the standard Diabetes Prevention Program (DPP), delivered remotely.

The main goal was a “composite outcome,” meaning participants had to achieve one or more of these by 12 months: lose weight, increase weekly physical activity, or lower blood sugar (measured as HbA1c), while keeping HbA1c under a healthy threshold.

What They Found

After one year, 31.7% of people in the AI‑led group and 31.9% in the human‑led group reached the composite outcome — essentially the same result. This showed that the AI program was “noninferior” to human coaching.

More people started and completed the AI program: 93.4% began it versus 82.7% in the human-led group, and 63.9% completed it versus 50.3%. Overall, AI-based prevention worked as well as human coaching, and more participants engaged with it when it was automated.

Why It Matters

Millions of adults in the U.S. have prediabetes but don’t join prevention programs because of scheduling, lack of access, or shortage of coaches. AI‑led lifestyle programs could make diabetes prevention easier, more accessible, and scalable, reaching people who otherwise wouldn’t participate.

This study is one of the first large trials to show that AI‑driven prevention can match human-led efforts — a major step for digital health.

What to Keep in Mind

The study measured weight loss, activity, and blood sugar, not whether it prevented diabetes over many years. Participants were mostly middle-aged volunteers from only two U.S. sites, so results might differ in more diverse populations. Researchers suggest more studies to test AI programs in different groups, real-world settings, and over longer periods.