Introduction and Objective: Limited patient engagement and suboptimal adherence remain major barriers in type 2 diabetes management. Digital conversational support tools may reinforce self-care between clinic visits. This study aimed to determine whether use of a digital conversational support tool, as an adjunct to usual care, is associated with improved behavioral and glycemic outcomes compared with usual care alone in adults with type 2 diabetes.Methods: This multicenter, real-world comparative study included adults with type 2 diabetes receiving OPD care. Participants using the digital conversational support tool for 6 months were matched 1:1 with usual-care controls based on age, sex, baseline HbA1c, diabetes duration, insulin use, and baseline self-care scores. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8), self-care behaviors using the Summary of Diabetes Self-Care Activities (SDSCA), and diabetes distress using the Diabetes Distress Scale (DDS-17). The primary outcome was change in HbA1c at 6 months.Results: Total 1,200 participants were included (600 intervention; 600 matched controls). Mean age 52.9 ± 10.7 years, and mean baseline HbA1c 8.3 ± 1.2%. At 6 months, HbA1c decreased from 8.4 ± 1.2% to 7.5 ± 1.0% in the intervention group compared with 8.3 ± 1.1% to 8.0 ± 1.0% in controls, yielding a between-group difference of −0.6% (p<0.001). High medication adherence (MMAS-8 ≥8) increased from 62.8% to 84.6% versus 63.4% to 68.1% in controls (p<0.001). SDSCA scores improved more (+1.5 vs +0.5; p<0.001), and DDS-17 scores declined by −0.7 versus −0.2 (p<0.001). Physical activity and SMBG frequency increased only in the intervention group.Conclusion: In this multicenter realworld comparative study, adjunctive use of a digital conversational support tool resulted in greater improvements in glycemic control, adherence, selfcare behaviors, and diabetes-related distress compared with usual care alone in adults with type 2 diabetes.
B. Saboo: None. S. Saboo: None. A. Modi: None. H. Hirani: None. S. Samajdar: None.
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