A digitally delivered, healthcoach-assisted 90-day lifestyle intervention produced statistically significantly greater reductions in HbA1c, fasting blood sugar, BMI, body weight, and waist circumference compared with standard of care alone, with greater benefit among high-adherence participants.
Key Findings
Results
The intervention group demonstrated significantly greater reductions in HbA1c compared with the control group over 90 days.
HbA1c reduction: 1.46 ± 1.82% in the intervention group vs. -0.07 ± 1.22% in the control group (p<0.001)
The intervention consisted of a structured lifestyle program covering diet, exercise, and mental wellness alongside standard of care (SOC)
The control group received SOC alone
The trial was a prospective, multicenter RCT with 149 participants (intervention n=87, control n=62)
Results
Fasting blood sugar (FBS) was significantly more reduced in the intervention group than in the control group.
FBS reduction: 18.83 ± 60.46 mg/dL in the intervention group vs. -10.84 ± 55.20 mg/dL in the control group (p<0.001)
The negative value in the control group indicates a slight average increase in FBS over 90 days
Assessment was conducted over a 90-day study period
Results
The intervention group showed significantly greater reductions in anthropometric measures including BMI, body weight, and waist circumference compared to controls.
Body weight reduction: 1.49 ± 2.22 kg (intervention) vs. 0.26 ± 2.57 kg (control), p<0.001
Waist circumference reduction: 1.86 ± 2.53 cm (intervention) vs. -0.09 ± 3.93 cm (control), p<0.001
The control group had a slight average increase in waist circumference over the study period
Results
Insulin resistance and beta-cell function markers showed favorable trends in the intervention group compared to the control group.
HOMA-IR decreased by 0.36 ± 6.63 in the intervention group vs. an increase of -0.27 ± 4.58 in the control group
HOMA of β-cell function (HOMA-B) improved by 36.28 ± 134.32 in the intervention group vs. 8.72 ± 79.1 in the control group
Statistical significance for these specific outcomes was not separately stated beyond the overall p<0.001 comparison
Results
Diabetes-related distress significantly improved in the intervention group, shifting from moderate to low/no distress, while the control group approached the threshold for moderate distress.
Weight reduction: 1.6 ± 2.3 kg (high-adherence) vs. 1.4 ± 2.1 kg (low-adherence)
Subgroups were stratified based on median composite adherence scores, with the threshold set at 35%
Statistical significance was assessed for adherence subgroup comparisons
Methods
The study enrolled 149 participants with type 2 diabetes across multiple centers in India, randomized to intervention and control groups.
Total participants: 149 (intervention n=87, control n=62)
Study design: prospective, multicenter randomized controlled trial (RCT)
Duration: 90 days
Setting: India, described as a 'resource-limited, real-world setting'
Registered under CTRI/2024/05/068043
What This Means
This research suggests that a 90-day digital lifestyle program, guided by health coaches and covering diet, exercise, and mental wellness, can meaningfully improve blood sugar control and other health measures in people with type 2 diabetes. Participants who received the digital program alongside their usual diabetes care saw their HbA1c (a measure of average blood sugar over several months) drop by about 1.46 percentage points, compared to virtually no change in those receiving usual care only. They also lost more weight, reduced their waist size, and experienced less diabetes-related emotional distress, with distress shifting from a 'moderate' level down to 'low or none.'
The study also found that people who engaged more with the program—classified as 'high adherence' based on how consistently they used the app and followed coaching—saw greater improvements in blood sugar and weight compared to those who engaged less. This suggests that the more consistently someone participates in such a program, the more benefit they are likely to receive.
This research is notable because it was conducted in a real-world, multicenter setting in India, a country with a very high burden of type 2 diabetes and limited healthcare resources. The findings suggest that structured, digitally delivered lifestyle programs supported by health coaches could be a practical and scalable tool to improve diabetes management beyond medication alone, particularly in settings where access to in-person specialist care may be limited.
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Mehra C, Raymond A, Saboo B, Jagadeesha A, S M K, Sabharwal M, et al.. (2026). Clinical outcomes of a digitally delivered structured lifestyle program in type 2 diabetes: a randomized controlled trial from India.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1920317