A smartphone app-based lifestyle change program for prediabetes (D’LITE Study) in a multiethnic asian population: a randomized controlled trial.
Open accessAbstract
Introduction: Landmark studies have established that lifestyle interventions focused on weight loss, diet modification and physical activity can prevent diabetes progression. However, the effectiveness of mobile health application among Asians with prediabetes remains largely unexamined. We aimed to assess whether a smartphone app-based lifestyle intervention program would lead to weight loss, normoglycemia and improved metabolic indices in a multiethnic Asian population with prediabetes. Research Design and Methods: This multicentre prediabetes RCT is part of the Diabetes Lifestyle Intervention using Technology Empowerment (D'LITE) trial. Adults ( n = 148) with prediabetes and BMI ≥ 23 kg/m 2 were randomly allocated either to the intervention group ( n = 72) empowered by self-monitoring features of the Nutritionist Buddy Diabetes app with in-app dietitian coaching for 6 months, or the control group ( n = 76) receiving standard diet counseling at baseline. Primary outcome was defined as change in body weight at 6 months, while secondary outcomes included glycemic control and other metabolic indices analyzed using Generalized Linear Mixed Model analysis with intention-to-treat approach. Results: Intervention group achieved a significantly greater weight loss of 4.2 vs. 1.3 kg [mean difference of −3.1 kg (95% CI −4.5 to −1.7), p < 0.001], and a 4.3-fold increased likelihood of achieving ≥ 5% weight loss, as compared to the control group at 6 months. The likelihood of achieving normoglycemia (defined as HbA 1c < 5.7%) was 2.1 times higher in intervention group than in the control group ( p < 0.018). Changes to blood pressure, total and LDL cholesterol were not statistically significant. Conclusion: An app-based lifestyle program led to clinically significant weight loss and improved glycemia, and can potentially augment current standard care in the prevention of diabetes among an Asian multiethnic population. Clinical Trial Registration: anzctr.org.au , identifier: ACTRN12617001112358.
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Despite CDC recognition of digital DPPs since 2015, limited RCT evidence has evaluated their effectiveness, with no trials comparing them directly to the criterion-standard DPP.
“Despite CDC recognition of digital DPPs since 2015, limited RCT evidence has evaluated their effectiveness, with no trials comparing them directly to the criterion-standard DPP.14-19,37”
From An AI-Powered Lifestyle Intervention vs Human Coaching in the Diabetes Prevention Program: A Randomized Clinical Trial (2025) · cites this paper as [17]
The Discussion (page unavailable) calls D’LITE one of the few RCTs assessing a mobile app with virtual dietitian coaching, supporting the limited-RCT-evidence portion for that specific intervention. The Methods describe a comparison with standard dietary advice, not the criterion-standard DPP, but the paper does not establish that no trials made that comparison. Our copy also does not state that the CDC has recognized digital DPPs since 2015. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPrior randomized trials of digital DPP adaptations did not include fully automated AI-based experimental groups or a human-led DPP control group.
“Although previous randomized trials have assessed digital adaptations of the DPP, none had experimental groups that were fully automated and AI-based and none used a human-led DPP control group.14-19”
From An AI-Powered Lifestyle Intervention vs Human Coaching in the Diabetes Prevention Program: A Randomized Clinical Trial (2025) · cites this paper as [17]
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- Authors
- Lim, S. L., Ong, K. W., Johal, J., Han, C. Y., Yap, Q. V., Chan, Y. H., Zhang, Z. P., Chandra, C. C., Thiagarajah, A. G., & Khoo, C. M.
- Affiliations
- National University Hospital (SG)
- National University of Singapore (SG)
- National University Polyclinics (SG)
- Corresponding author
- Lim, Su Lin
- Venue
- Frontiers in Nutrition
- Publisher
- Frontiers Media SA
- Published
- 2022-01-24
- Volume
- 8
- Pages
- 780567-780567
- ISSN
- 2296-861X (ISSN-L)
- PMC
- PMC8819073
- OpenAlex
- W4207077721
- Cited by
- 61
- References
- 30
- Citations by year
- 2026: 7 · 2025: 16 · 2024: 17 · 2023: 15 · 2022: 6
- FWCI
- 15.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Nutrition (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Medical Research Council
- National Medical Research Council (NMRC/HSRG/0063/2016)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Physical Sciences › Computer Science › Information Systems › Mobile Learning in Education
- Keywords
- prediabetes, mobile health, mobile application, lifestyle intervention, weight loss, glycemic control, HbA1c, self-monitoring, diabetes prevention, multi-ethnic Asian population
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