Evidence map›Paper›PMID 42757240›Full record

ArticleFrontiers in medicine2026

AI Chatbots as a source of Ramadan medication management advice for patients with diabetes: a multilingual comparative evaluation.

Sufyan Alomair, Maryam Alsuwayq, Walaa Alabbad, Khawlah Albeladi, Zainab Alhassan

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Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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5 authors.

Sufyan AlomairDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa, Saudi Arabia.
Maryam AlsuwayqDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa, Saudi Arabia.
Walaa AlabbadDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa, Saudi Arabia.
Khawlah AlbeladiDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa, Saudi Arabia.
Zainab AlhassanDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Patients with diabetes increasingly consult artificial intelligence (AI) chatbots for medical advice, including guidance on antidiabetic medication management during Ramadan fasting, because AI can simplify and summarize long, complex guidelines. Also, in hospital settings, these tools are being used in hospitals much faster than it takes to establish formal regulations and guidelines for their use. Evaluations of the accuracy, completeness, and reproducibility of such advice across languages are still lacking. Therefore, the study aims to evaluate and compare the accuracy, completeness, safety, and reproducibility of three widely used AI chatbots-ChatGPT, Google Gemini, and Microsoft Copilot-when providing antidiabetic medication adjustment advice during Ramadan in both English and Arabic. Methods: Twenty-three standardized clinical scenarios covering common antidiabetic regimens were presented to each chatbot in both English and Arabic. Each query was repeated to evaluate reproducibility, resulting in 276 responses scored. Responses were assessed against the International Diabetes Federation-Diabetes and Ramadan (IDF-DAR) Guidelines using a 0-2 accuracy scale, a 0-4 completeness scale, and a 0-3 safety scale. Results: Overall, 77% of responses were fully consistent with the guideline, 12% were partially consistent, and 11% (30/276) contained clinically harmful or contradictory advice; harmful responses were about twice as common in Arabic as in English (14% vs. 8%). Completeness and safety were high, with medians at the observed ceiling. In the generalized linear mixed models, chatbots did not differ significantly in accuracy, completeness, or safety, and there was no significant main effect of language or chatbot × language interaction; the strongest signals were a chatbot effect on completeness ( Conclusions: AI chatbots demonstrated comparable performance in delivering guideline-based advice for diabetes management during Ramadan, with no significant differences in accuracy, completeness, or safety. While most responses aligned with the IDF-DAR guideline, some harmful recommendations persisted, and response consistency fluctuated over time. These results suggest that AI chatbots should serve as a supplementary resource rather than a substitute for professional medical advice.

Indexed as

artificial intelligenceChatGPTCopilotdiabetes mellitusGeminimedication safetyRamadan

Identifiers

PMID42757240
PMCPMC13584903

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.