Researchers are testing a new way to help people with type 2 diabetes manage their condition using simple phone calls powered by artificial intelligence. The study focuses on rural areas where people often have less access to doctors and technology. Participants receive daily automated calls that ask about their diet, exercise, and blood sugar levels, plus weekly coaching from a real person. Some people earn fixed daily rewards for participating, while others earn rewards that increase if they stay engaged. This pilot study with 88 participants aims to see if this low-tech approach actually works and is practical for real people living in rural communities.

The Quick Take

  • What they studied: Whether daily automated phone calls combined with AI coaching and money rewards can help people with type 2 diabetes better control their blood sugar levels in rural areas.
  • Who participated: 88 adults with type 2 diabetes living in rural areas who had blood sugar control levels between 6.5% and 11.5% (indicating their diabetes needed better management).
  • Key finding: This is a pilot study testing whether the program is practical and feasible—the full results on blood sugar improvement are still being analyzed as of the publication date.
  • What it means for you: If you live in a rural area and have type 2 diabetes, this approach may offer a simple, phone-based way to get support without needing fancy technology or frequent doctor visits. However, this is still early-stage research, so talk to your doctor before making any changes.

The Research Details

This is a pilot study, which means it’s a small test run before doing a bigger research project. Researchers recruited 88 adults with type 2 diabetes in rural areas and split them into different groups. Some groups received coaching from an AI-powered system, while others got coaching from real people. The study also tested two different reward systems: one where people earned the same amount every day, and another where rewards increased if they stayed engaged.

Participants received daily automated phone calls that asked simple questions about what they ate, how much they exercised, whether they took their medicine, and their blood sugar readings. Once a week, they got coaching based on their answers and their assigned group. The study tracked how many people actually participated, how satisfied they were, and whether their blood sugar control improved.

This research used a framework called MOST (Multiphase Optimization Strategy), which is a structured way to test different parts of a program to see what works best before running a full-scale study.

Rural areas often have fewer doctors, hospitals, and people with high-speed internet, making it hard for people with diabetes to get regular care. This study matters because it tests whether a simple phone-based system can work in these areas. By using automated calls and AI, the program doesn’t require fancy technology or frequent in-person visits. Understanding what works in rural settings could help millions of people who struggle to access diabetes care.

This is a well-designed pilot study funded by the National Institute of Diabetes and Digestive and Kidney Diseases, a respected government health agency. The study was registered on ClinicalTrials.gov, which means it followed strict research standards. However, because this is a pilot study with only 88 participants, the results are preliminary and need to be confirmed with larger studies. The researchers also collected feedback directly from participants through interviews, which adds real-world perspective to the numbers.

What the Results Show

As of the publication date (December 2025), the researchers had enrolled all 88 participants and finished collecting their data. However, the detailed analysis of whether blood sugar levels actually improved is still being completed. The study was designed to measure two main things: whether the program was practical and feasible for rural participants, and whether it showed early signs of helping control blood sugar.

The study tested whether automated AI coaching worked as well as coaching from real people, and whether fixed daily rewards ($0.60 per day) motivated people better than rewards that started smaller ($0.20) but increased if they stayed engaged. These comparisons will help researchers design a bigger study in the future.

Participants received daily interactive voice response calls—essentially automated phone calls that asked questions and recorded their answers. This low-tech approach was chosen specifically because rural areas often have basic phone service even when internet is unreliable. The fact that all 88 participants completed the study suggests the program was acceptable to people in rural communities.

The researchers also collected detailed feedback from participants through interviews about their experience with the program. This qualitative information helps explain not just whether the program worked, but how people felt about it and what barriers they faced. Understanding participant satisfaction is crucial for knowing whether a program will actually be used by real people in real life, not just in a research setting.

Previous telehealth studies for diabetes have shown promise, but many failed because rural patients had trouble using the technology or couldn’t access it reliably. This study builds on that knowledge by using simpler technology (basic phone calls instead of apps or internet portals) and testing whether financial incentives can boost participation. The use of AI to personalize coaching is newer and reflects advances in how technology can adapt to individual needs without requiring constant human attention.

This is a pilot study, so it’s smaller and shorter than a full research trial. With only 88 participants, results may not apply to all rural populations. The study doesn’t yet show whether blood sugar actually improved significantly. Because this is testing a new program, we don’t know yet how long the benefits last or whether people keep using it after the study ends. The study also focuses on rural areas, so results may not apply to urban or suburban populations. Finally, the detailed results on blood sugar improvement were still being analyzed at publication time.

The Bottom Line

If you have type 2 diabetes and live in a rural area with limited access to diabetes care, ask your doctor whether a phone-based coaching program like this might help you. This approach shows promise because it uses simple technology and provides regular support. However, this is still early-stage research, so it’s not yet a standard treatment recommendation. Work with your healthcare provider to decide if this fits your situation. Confidence level: Moderate—this is promising pilot data, but larger studies are needed.

This research is most relevant for people with type 2 diabetes living in rural areas who struggle to access regular diabetes care. It may also interest healthcare providers and public health officials working in rural communities. People with type 2 diabetes in urban areas with good access to doctors may not need this approach. This study is not designed for people with type 1 diabetes or other types of diabetes.

In this pilot study, participants received daily calls and weekly coaching for several months. Researchers typically need 3-6 months to see meaningful changes in blood sugar control (measured by HbA1c levels). However, this is a pilot study, so the full timeline for benefits isn’t yet clear. If larger studies confirm these results, it could take 1-2 years before this becomes available as a standard treatment option.

Want to Apply This Research?

  • Track daily engagement with your diabetes management program by logging: (1) whether you completed your daily automated call, (2) your blood glucose readings, (3) meals eaten, and (4) minutes of physical activity. Measure success by consistency over 4-week periods rather than daily perfection.
  • Set a specific time each day to answer your automated coaching call (for example, right after breakfast). If using a rewards system, check your earned incentives weekly to stay motivated. Share your weekly coaching feedback with a family member or friend for accountability.
  • Check your blood sugar control every 3 months through your doctor’s HbA1c test. Track your daily engagement percentage (days you completed calls divided by total days). Note any changes in how you feel, energy levels, and diabetes symptoms. Review your weekly coaching summaries to identify patterns in what helps you manage your diabetes best.

This research describes a pilot study testing a new diabetes management approach. It is not yet proven as a standard treatment. If you have type 2 diabetes, do not change your current treatment plan without talking to your doctor first. This study is still in early stages, and larger research is needed to confirm whether it actually improves blood sugar control. Always work with your healthcare provider to make decisions about your diabetes care. This information is educational and should not replace medical advice from your doctor or diabetes educator.