AI活用による糖尿病予防が有望な結果を示す(AI-powered diabetes prevention program shows promise)

2025-10-292025-12-09

2025-10-27 ジョンズ・ホプキンス大学 (JHU)

ジョンズ・ホプキンス大学医学部とブルームバーグ公衆衛生大学院の研究によると、AIが主導する糖尿病予防アプリは、人間指導型プログラムと同等の効果を示した。米国成人の約9,760万人が前糖尿病状態にあるが、従来の人間による生活指導プログラムは時間的制約などで普及が限られていた。研究チームは、完全自動AIが食事・運動習慣の改善を支援する介入を実施し、1年後にCDC基準のリスク低減指標を満たす割合が人間指導と同水準であることを確認。これはAI主導の糖尿病予防アプリが第III相無作為化臨床試験で有効性を示した初の例である。AI介入は医療人材不足を補い、個別化された行動支援を大規模に展開できる可能性を持つ。研究成果は『JAMA』誌に掲載。

<関連情報>

糖尿病予防プログラムにおけるAIを活用したライフスタイル介入と人間によるコーチングランダム化臨床試験 An AI-Powered Lifestyle Intervention vs Human Coaching in the Diabetes Prevention Program A Randomized Clinical Trial

Nestoras Mathioudakis, MD, MHS; Benjamin Lalani, BS; Mohammed S. Abusamaan, MD, MPH;et al
JAMA Published Online: October 27, 2025
DOI:10.1001/jama.2025.19563

Key Points

Question How does referral to a lifestyle intervention exclusively driven by artificial intelligence (AI) compare with referral to a human coach–led Diabetes Prevention Program (DPP) lifestyle intervention?

Findings In this randomized clinical trial involving 368 adults with overweight or obesity and prediabetes, 31.7% of participants randomized to referral to an AI-led DPP and 31.9% of participants randomized to referral to a human-led DPP group achieved the primary composite outcome (5% weight loss, 4% weight loss plus 150 minutes of physical activity per week, or an absolute hemoglobin A_1c reduction of ≥0.2 percentage points with hemoglobin A_1c maintained at <6.5% throughout the study duration) at 12 months, a difference that met the prespecified noninferiority criterion of 15%.

Meaning Among adults with prediabetes and overweight or obesity, a fully automated AI-led DPP may be a viable alternative to a DPP led by human coaches.

Abstract

AI-Powered Lifestyle Intervention vs Human Coaching in the Diabetes Prevention Program
Visual Abstract.

Importance Prediabetes is common, yet evidence-based lifestyle interventions are underutilized.

Objective 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 in achieving recommended thresholds for weight loss, hemoglobin A_1c (HbA_1c) reduction, and weekly physical activity among adults with prediabetes and overweight or obesity.

Design, Setting, and Participants This phase 3, parallel-group, pragmatic, noninferiority randomized clinical trial was conducted from October 11, 2021, to December 16, 2024 (last follow-up) at 2 US clinical sites in Baltimore, Maryland, and Reading, Pennsylvania. Adults 18 years or older with prediabetes and overweight or obesity were enrolled.

Interventions Participants were randomized in a 1:1 ratio to receive either a referral to an AI-powered DPP lifestyle intervention delivered via a mobile app and Bluetooth-enabled digital scale or a referral to a human coach–led DPP lifestyle intervention delivered remotely. Both interventions were delivered independently of the study team over a 12-month period.

Main Outcomes and Measures The primary outcome was a composite of maintaining an HbA_1c less than 6.5% throughout the study and achievement of at least 5% weight loss, at least 4% weight loss plus at least 150 minutes of weekly physical activity (assessed with actigraphy), or an absolute reduction in HbA_1c of at least 0.2 percentage points at 12 months. Noninferiority of referral to the AI-led DPP compared with referral to the human-led DPP was prespecified to be determined if the 1-sided 95% CI lower boundary of the risk difference did not cross -15%.

Results A total of 368 participants were included (median [IQR] age, 58 [50-65] years; 71% were female, 27% were Black, 6% were Hispanic, and 61% were White; median [IQR] BMI, 32.3 [28.5-37.1]). After referral, 171 of 183 participants (93.4%) initiated the AI-led DPP and 153 of 185 (82.7%) initiated the human-led DPP. The primary outcome was achieved by 58 of 183 participants (31.7%) in the AI-led DPP group and 59 of 185 (31.9%) in the human-led DPP group (risk difference, -0.2% [1-sided 95% CI, -8.2%]), meeting the criterion for noninferiority. Findings were consistent across individual components of the composite end point and in sensitivity analyses.

Conclusions and Relevance 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.

Trial Registration ClinicalTrials.gov Identifier: NCT05056376