Encouraging Physical Activity In Patients With Diabetes Through Automatic Personalized Feedback Via Reinforcement Learning Improves Glycemic Control

Most patients with type 2 diabetes are sedentary despite the clear benefit of regular physical activity, including better glucose control and improvement in quality of life (1). Smartphones could potentially improve patient care by continual communication with patients and sensors that quantify patient behavior (2). Nevertheless, the use of personalized messages that take into account the actual behavior of patients and learn to reinforce it has not yet been reported.We provided a total of 27 patients with type 2 diabetes who did not perform regular physical activity prior to recruitment with a pedometer installed on their personal smartphones and a personal plan for physical activity. Patients were randomized into a control group ( n = 7) and a treatment group ( n = 20), and received text messages (via the Short Message Service [SMS] on the smartphone) one to seven times a week to encourage physical activity. In the treatment group, the messages consisted …