Li Zhi, Luo Dahang, Li Zhongjin
Endocr Connect. 2025 Feb 24;14(4). doi: 10.1530/EC-24-0576. Print 2025 Apr 1.
The incidence of type 2 diabetes mellitus (T2DM) is rising among young adults, posing challenges for long-term management after discharge.
This prospective comparative study included 120 newly diagnosed young adults with T2DM admitted between January and December 2023. Participants were randomized into intervention or control groups (n = 60 each). All patients received standard diabetes education and short-term insulin pump intensive therapy during hospitalization. After discharge, the control group received traditional care, while the intervention group utilized an internet-based management system incorporating continuous glucose monitoring, personalized feedback and remote healthcare team consultations. Primary outcomes included HbA1c, fasting blood glucose (FBG), insulin resistance (HOMA-IR) and β-cell function (HOMA-β and fasting C-peptide). Secondary outcomes included lipid profiles, renal function (urine albumin/creatinine ratio (UACR)), blood pressure, quality of life (SF-36) and depression scores (PHQ-9).
At 12 months, the intervention group had significantly lower HbA1c (6.5 vs 7.2%, P < 0.001) and better improvements in FBG, HOMA-IR, HOMA-β, fasting C-peptide, triglycerides and low-density lipoprotein cholesterol (P < 0.01). Improvements in UACR and blood pressure were minimal (P > 0.05). SF-36 and PHQ-9 scores improved more significantly in the intervention group (P < 0.01). Diabetes remission rates were higher in the intervention group (60 vs 37%, P = 0.028) and remained significant after adjusting for baseline variables (P = 0.015).
The internet-based management system with personalized feedback significantly improved glycemic control and quality of life in young adults with T2DM.
2型糖尿病(T2DM)在年轻成年人中的发病率正在上升,这给出院后的长期管理带来了挑战。
这项前瞻性比较研究纳入了2023年1月至12月期间收治的120例新诊断的年轻T2DM患者。参与者被随机分为干预组或对照组(每组n = 60)。所有患者在住院期间均接受了标准的糖尿病教育和短期胰岛素泵强化治疗。出院后,对照组接受传统护理,而干预组使用基于互联网的管理系统,该系统包括持续血糖监测、个性化反馈和远程医疗团队咨询。主要结局指标包括糖化血红蛋白(HbA1c)、空腹血糖(FBG)、胰岛素抵抗(HOMA-IR)和β细胞功能(HOMA-β和空腹C肽)。次要结局指标包括血脂谱、肾功能(尿白蛋白/肌酐比值(UACR))、血压、生活质量(SF-36)和抑郁评分(PHQ-9)。
在12个月时,干预组的HbA1c显著更低(6.5%对7.2%,P < 0.001),并且在FBG、HOMA-IR、HOMA-β、空腹C肽、甘油三酯和低密度脂蛋白胆固醇方面有更好的改善(P < 0.01)。UACR和血压的改善极小(P > 0.05)。干预组的SF-36和PHQ-9评分改善更显著(P < 0.01)。干预组的糖尿病缓解率更高(60%对37%,P = 0.028),在调整基线变量后仍具有显著性(P = 0.015)。
具有个性化反馈的基于互联网的管理系统显著改善了年轻T2DM患者的血糖控制和生活质量。