Evaluating large language models using the Type 2 Diabetes Health Education guideline: a comparative analysis of ChatGPT-4.1, Claude-4.0, DeepSeek-V3, and ERNIE Bot 4.5 Turbo.

Objective: To systematically evaluate the quality and readability of health information generated by four large language models (LLMs) in response to inquiries regarding type 2 diabetes mellitus (T2DM), using an authoritative Chinese clinical guideline as the reference standard. Methods: A total of 124 standardized questions were extracted from the Chinese Type 2 Diabetes Popular Science Guidelines. Six endocrinologists and diabetes specialists conducted independent, blind evaluations using the CLEAR tool (Completeness, Lack of false Information, Evidence, Appropriateness, Relevance) and PEMAT-P (Patient Education Materials Assessment Tool for Printable materials). Response characteristics were also recorded. Between-model differences were tested using the Kruskal-Wallis H test with Bonferroni pairwise comparisons. Results: All four models achieved total CLEAR scores within the "very good" range (19-25), with no significant differences seen between models (χ Conclusion: Although the four LLMs generally provide accurate and pertinent information regarding type 2 diabetes, enduring limits in actionability and inconsistencies among models in content completeness and understandability restrict their effective use in diabetic patient education. Future development should prioritize stronger step-by-step behavioral guidance and differentiated, scenario-specific model deployment to enhance their value in patient-facing diabetes self-management support.