Strategies are needed to expand diabetes education and support among persons with diabetes (PWD) . We designed a personalized conversational agent (“chatbot”) to provide diabetes education and monitoring. Feasibility and preliminary efficacy were assessed in a pilot cohort of adults with type 2 diabetes (T2DM) .

Primary care patients with T2DM and an A1C of 8.0 - 8.9% were recruited from 4 sites in a regional health care system. Patients received proactive text/email notifications from the web-based chatbot which integrated assessment of self-knowledge and self-reported care behaviors, such as medication taking and checking blood glucose, with video and written educational content. Chat frequency started at once weekly, and content was delivered up to 12 months.

Between November 2020 and October 2021, 112 (84%) of 132 invited PWD agreed to enroll. Enrollees were predominantly African American (65%) and female (60%) , with mean age 58.3 +/- 10.6. Account activation was completed by 86 enrollees (77%) . Of those, 85% (76) completed at least one subsequent education chat. Amongst those 76 enrollees, 97% were very satisfied/satisfied with the chats and 84% strongly agreed/agreed that the chats made them feel more confident in managing their health. Participants have completed 914 chats over 12 months with 10,6data points collected. Only 5% disenrolled. There were no changes in self-reported medication adherence. Follow-up A1C was available for 71 participants. Participants who completed at least one educational chat had a 0.34 percentage point decrease in mean A1C vs. a 0.2 percentage point increase for participants who did not complete any educational chats, a difference of 0.54 between the 2 groups (p=0.089) .

This pilot study demonstrates patient acceptability and satisfaction and suggests improvement in A1C and self-care confidence in a primary care population. Future research with a larger population will be needed to validate these early findings.


M.F.Magee: None. C.M.Nassar: None. R.Dunlea: Employee; Conversa Health / American WEll. B.James: None. A.R.Montero: None. P.Sack: None. A.Tweedt: None. D.Vetal: Employee; Conversa Health. N.K.Cobb: None.

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