The influence of information platform based personalized self- management prescription on type 2 diabetes in China: A real-world cohort study

Background and aim: Diabetes self-management education programs have been shown to improve patients' health outcomes, and Internet technology have provided more ways for diabetes management. However, it is difficult for patients to grasp all the information during a short period of consultation time. In this study, we implemented a fully integrated regional diabetes management model that information platform-based personalized prescription, and evaluated its feasibility and effectiveness among patients with type 2 diabetes( T2DM). Design: This was a 12-month long, multi-centered, prospective, and open-labeled cohort study. In this study, 1452 eligible participants with T2DM were enrolled and randomized to an intervention (n = 726) or a control (n = 726) group from April 2022 to April 2023. All patients underwent integrated management through an information platform. The intervention group was provided individualized self-management prescriptions, while the control group received routine care. Findings: 1342 patients completed valid observations, 655 in the intervention group and 688 in the control group. The intervention group showed significant HbA1c and fasting plasma glucose(FPG) reduction (1.92% (mmol/mol) and 3.23mmol/L) at the first follow-up time, and 57% HbA1c (373) and 68%FPG (474) patients reached treatment target rate (HbA1c ≤ 7% (mmol/mol), FPG ≤ 7mmol/L), compared with the control group (HbA1c = 1.31% (mmol/mol),26% (179) and FPG = 2.31mmol/L,39% (265)). Meantime, the intervention group showed significant improvements in the frequency of SMBG, the incidence of hypoglycemia, BMI, UACR, and blood lipids after the intervention compared with a control group and baseline (all p < 0.05), except the TC (p = 0.53 baseline vs. after intervention). The co-primary outcomes were achieved by 119 people (18%) in the intervention group, and this was significantly higher than the control group (38 (6%), P < 0.001). Moreover, the achieved co-primary outcomes rate is higher among middle-aged (19%) and female (19%) patients in the intervention group. Conclusions The platform-based diabetes self-management prescriptions provided feasible and effective in the management of T2DM, also can promote the remission rate of diabetes. But need to justifying their integration into clinical practice, with cholesterol management needs to be improved.