Evidence map›Paper›PMID 42879781›Full record

SynthesisJournal of medical Internet research2026

AI-Driven Lifestyle Interventions for Reducing Diabetes Risk: Systematic Review.

Obinna I Ekwunife, Tyler Nauta, Raphael A Fraser, Jennifer A Campbell, Gloria Aidoo-Frimpong, Rebekah J Walker, Leonard E Egede

Abstract readSystematic ReviewReview
In one paragraph

Synthesis in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Obinna I EkwunifeDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.ORCID https://orcid.org/0000-0003-0879-3861
Tyler NautaDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.ORCID https://orcid.org/0009-0009-9113-7435
Raphael A FraserDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.ORCID https://orcid.org/0000-0002-1667-390X
Jennifer A CampbellDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.ORCID https://orcid.org/0000-0002-5878-6283
Gloria Aidoo-FrimpongDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States.ORCID https://orcid.org/0000-0002-4658-2953
Rebekah J WalkerDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.ORCID https://orcid.org/0000-0002-7773-557X
Leonard E EgedeDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.ORCID https://orcid.org/0000-0003-1546-1515

Funding

Financial Incentives And Nurse Coaching to Enhance Diabetes Outcomes (FINANCE-DM) - Diversity SupplementR01DK120861 · NIDDK · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI EGEDE, LEONARD E. · 2019 to 2023
$3.4M
Lowering the Impact of Food insecurity in African American Adults with Type 2 Diabetes Mellitus (LIFT-DM) - Diversity SupplementR01MD013826 · NIMHD · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI EGEDE, LEONARD E., WALKER, REBEKAH J · 2019 to 2023
$3.4M
Structural Racism and Disparities in Social Risk, Human Capital, Health Care Resources, and Health Outcomes: A Multi-level Analysis of Pathways and Policy Levers for ChangeR01MD017574 · NIMHD · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI Leonard E. Egede, Sebastian Linde · 2023 to 2026
$2.5M
Impact of structural racism on hospital/clinic closures, community assets, and health outcomes in urban communitiesR01MD018012 · NIMHD · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI Leonard E. Egede, Sebastian Linde · 2023 to 2026
$2.4M
Cardiovascular Risk Reduction for Adults with Food Insecurity Using Structured Incentives (CVD-FIT)R01MD018721 · NIMHD · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI Rebekah J Walker · 2024 to 2026
$2.0M
Conditional Cash Transfer Intervention to Improve Health Outcomes among Inner-City African Americans with T2DMK01DK131319 · NIDDK · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI Jennifer Annette Campbell · 2022 to 2026
$682k
NIDDK NIH HHS K01 DK131319NIDDK NIH HHS R01 DK120861NIMHD NIH HHS R01 MD013826NIMHD NIH HHS R01 MD017574NIMHD NIH HHS R01 MD018012NIMHD NIH HHS R01 MD018721
6 · The paper itself

Abstract

backgroundArtificial intelligence (AI)-driven lifestyle interventions are increasingly used for reducing diabetes risk. However, whether they produce clinical benefit beyond standard Diabetes Prevention Programs (DPPs) and whether effects vary by AI type, population, or delivery setting, remains uncertain.

objectiveThis study aimed to evaluate the effects of AI-driven lifestyle interventions on clinical, behavioral, and engagement outcomes among people with prediabetes or elevated diabetes risk and to assess whether effects differed by AI type, population, or delivery setting.

methodsPubMed, Embase, CINAHL, Web of Science, IEEE Xplore, ClinicalTrials.gov, and citation searches were completed on August 3, 2026, for English-language reports published from 2015. Eligible studies evaluated AI-driven digital lifestyle interventions among people with prediabetes or elevated diabetes risks, or healthy participants in feasibility studies. One reviewer (OIE) screened records and extracted data; a second reviewer (TN) independently verified exclusions and extraction. Study quality was assessed with National Heart, Lung, and Blood Institute tools appropriate to each design. Given substantial heterogeneity in designs, estimands, and outcome metrics, findings were synthesized narratively following the Synthesis Without Meta-Analysis guideline rather than pooled statistically.

resultsOf 8032 records, 11 studies were included: 1 randomized, 1 nonrandomized comparative, 4 observational, and 5 uncontrolled pre-post studies. Seven evaluated AI lifestyle coaching systems, 2 predictive AI platforms, and 2 conversational AI chatbots. Ten of 11 studies used commercially developed platforms. Study quality was rated good for 5 studies, fair for 3, and poor for 3. The randomized controlled trial showed noninferiority of an AI-DPP versus human coach-led DPP for the combined 12-month outcome (23/183, 12.6% vs 23/185, 12.4%; risk difference 0.1%, 1-sided 95% CI -5.5%). Program initiation (171/183, 93.4% vs 153/185, 82.7%; risk difference 10.7%, 95% CI 4.2%-17.3%) and completion (117/183, 63.9% vs 93/185, 50.3%; risk difference 13.7%; 95% CI 3.6%-23.7%) were higher with AI, but this did not translate into superior clinical outcomes. The nonrandomized comparison found no advantage of AI-personalized messaging over static messaging in terms of BMI or physical activity. The remaining studies reported uncontrolled changes precluding causal inference. Evidence was insufficient to determine whether effects differed by population or delivery setting.

conclusionsOne randomized trial supports noninferiority, not superiority, of a specific AI-driven DPP relative to human coaching; the remaining evidence was nonrandomized, predominantly commercially developed, and hypothesis-generating. To our knowledge, this is the first systematic review to stratify evidence on AI-driven diabetes prevention by AI mechanism-coaching, predictive, and conversational-and by outcome domain, extending prior scoping work that mapped apps without appraising study quality or comparative effectiveness. This structured mapping shows where evidence is the strongest (engagement and weight) and the weakest (glycemic causality and generalizability), giving health systems a concrete basis for deciding where AI-DPP tools may supplement, rather than replace, standard DPP delivery, pending independent, adequately powered randomized trials.

Indexed as

Artificial IntelligenceDiabetes Mellitus, Type 2Life StyleRisk Reduction BehaviorDigital HealthHumansPrediabetic Stateartificial intelligencediabetes preventiondigital healthlifestyle interventionsprediabetessystematic review

Identifiers

PMID42879781
PMCPMC13720412

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.