Are conversational agents used at scale by companies offering digital health services for the management and prevention of diabetes?

Successful interventions to prevent and manage type 2 diabetes rely on long-term, day-today decisions which take place outside of clinical settings. In this context, human resources are difficult to scale up, and leveraging Conversational agents (CAs) could be one way to scale up healthcare to tackle the emerging epidemic of type 2 diabetes. The objective of this paper is to assess the degree to which CAs are employed by top-funded digital health companies that target the prevention and management of type 2 diabetes. Companies were identified via two venture capital databases, i.e. Crunchbase Pro and Pitchbook. Two independent reviewers screened results and the final list of companies was validated and revised by three independent digital health experts. The companies' digital services (usually mobile applications) were accessed and reviewed for the utilisation of CAs. To better understand the purpose of identified CAs, relevant publications were identified via PubMed, Google Scholar, ACM Digital Library and on the companies' website. Nine out of 15 companies' digital services were accessible to the authors and only in one case a CA was employed. The uptake of CAs by top-funded digital health companies targeting type-2 diabetes is still low.