AI-Powered Diabetes Prevention Program Intervention Matches Human Coaching: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On October 27, 2025, we reported on findings from a study published in JAMA that was designed to determine whether referral to an exclusively artificial intelligence (AI)–led lifestyle intervention based on the Diabetes Prevention Program (DPP) is noninferior to referral to a human-led DPP.

The study

For the parallel-group, pragmatic noninferiority trial, conducted from October 2021 to December 2024, researchers enrolled 368 middle-aged adults (median age 58 years) with prediabetes and overweight or obesity from 2 US clinical sites in Maryland and Pennsylvania. The cohort was 71% women; 61% self-identified as White, 27% as Black, and 6% as Hispanic.

Participants were randomly assigned to receive referral to either a fully automated AI-powered DPP mobile app powered by reinforcement learning algorithms or 1 of 4 CDC-recognized human coach-led programs. A critical component of the study, according to the authors, the research team did not promote engagement after referral, following up only at 6 and 12 months to assess real-world effectiveness.

The primary composite outcome required maintaining HbA_1c below 6.5% throughout the study plus achieving at least one of the following:

• 5% weight loss

• 4% weight loss combined with 150 minutes of weekly moderate-to-vigorous physical activity

• Absolute HbA_1c reduction of 0.2 percentage points

The findings

Results showed that 31.7% of participants referred to the AI-powered program and 31.9% referred to human coaching met CDC benchmarks for diabetes risk reduction at 12 months, a difference that met the prespecified criterion for noninferiority. Notably, the AI program demonstrated higher rates of both initiation (93.4% vs 82.7%) and completion (63.9% vs 50.3%) compared with traditional programs.

Authors' comments

"Among adults with prediabetes and overweight or obesity, referral to a fully automated AI-led DPP was noninferior to referral to a human-led DPP in achieving a composite outcome based on weight reduction, physical activity, and HbA_1c."

Click here for more details.