ChatCLIDS: Simulating Persuasive AI Dialogues to Promote Closed-Loop Insulin Adoption in Type 1 Diabetes Care

Abstract

Real-world adoption of closed-loop insulin delivery systems (CLIDS) in type 1 diabetes remains low, driven not by technical failure, but by diverse behavioral, psychosocial, and social barriers. We introduce ChatCLIDS, the first benchmark to rigorously evaluate LLM–driven persuasive dialogue for health behavior change. Our framework features a library of expert-validated virtual patients, each with clinically grounded, heterogeneous profiles and realistic adoption barriers, and simulates multi-turn interactions with nurse agents equipped with a diverse set of evidence-based persuasive strategies. ChatCLIDS uniquely supports longitudinal counseling and adversarial social influence scenarios, enabling robust, multi-dimensional evaluation. Our findings reveal that while larger and more reflective LLMs adapt strategies over time, all models struggle to overcome resistance, especially under realistic social pressure. These results highlight critical limitations of current LLMs for behavior change, and offer a high-fidelity, scalable testbed for advancing trustworthy persuasive AI in healthcare and beyond.