VA|PREVENTION: Randomized Controlled Trial of a Person-Centred Digital Intervention to Prevent Diabetes in High-Risk Adults

Inclusion Criteria:

• Age ≥ 18 years old;

• FINDRISC Score ≥12 (moderate, high or very high) and/or prediabetes, defined aseither:

• HbA1c between 5.7%-6.4% within the last two years; or

• Impaired Glucose Tolerance (IGT) based on an Oral Glucose Tolerance Test (OGTT)at the 120-minute mark, with values between 140 and 199 mg/dL in the past threeyears;

• Able to understand, speak and write Portuguese;

• Able to provide written informed consent;

• Access to a smartphone, tablet or computer with internet connection;

• Plan to reside in the recruitment/study area for the next 10 months

Exclusion Criteria:

• Established Type 1 and 2 Diabetes Mellitus diagnosis;

• Pregnancy - Self-reported as currently pregnant, planning to become pregnant, or notpracticing contraception, in the following 10 months (if applicable);

• Conditions precluding technology use (e.g. cognitive decline, dependent upon a carerfor daily activities);

• Use of anti-obesity or diabetes medication, such as Metformin, Glucagon-likepeptide-1 analogue (GLP-1), or other medications known to significantly impactweight (either gain or loss), currently or within the preceding 3 months;

• Following a prescribed medical diet;

• Having undergone bariatric surgery within the past 3 years or planning surgerywithin the next 10 months;

• Any mental health condition, including, but not limited to, eating disorders oralcohol/substance abuse, that would impact fully participating on the study;

• Participating in a concurrent weight management program and/or relevantinterventional research protocol;

• Contraindication to physical activity or weight loss;

• Existing thyroid disorder;

• Active cancer or less than 6 months from treatment;

• Unable to provide informed consent or absence of a legal representative that canprovided it on behalf of the patient;

• Institutionalised adults;

• Foreseeable difficulty in attending study visits.