Zheng Chuanfen, Dou Xiong, Xiong Xiaotao, Lei En-Yu, Jiang Ming, Wu Yulin, Yu Jing, Wang Xianjun, Zhang Ling, Rong Honghui, Lu Lu, Li Fengju, Luo Ting, Ma Xiangyu, Chen Ji-An
Department of Health Education, College of Preventive Medicine, Army Medical University, 30 Gaotanyan Street, Shapingba District, Chongqing, 400038, China, 86 02368771579.
Xinqiao Community Health Service Center, Shapingba District, Chongqing, China.
JMIR Mhealth Uhealth. 2026 Feb 20;14:e80738. doi: 10.2196/80738.
China's diabetes epidemic faces critical gaps in glycemic control, with only 50.1% of treated patients achieving hemoglobin A1C (HbA1c) targets in 2021. Conventional interventions struggle with scalability in primary care, particularly for vulnerable populations.
This study aimed to evaluate the use of a WeChat-based health education tool (the WeWalk mini program, the Bayu Health public account, and a WeChat group) for improving glycemic control in community-dwelling patients with type 2 diabetes mellitus.
This multicenter randomized controlled trial enrolled 600 adults with type 2 diabetes from 3 communities in Chongqing, randomly allocating participants 1:1 to either a 12-week WeChat-based intervention (n=300, 50%) or a control group (n=300, 50%) in September 2020. The control group received 4 face-to-face traditional health education sessions, whereas the intervention group participated in a digital program: a 4-week course followed by an 8-week practical implementation. At baseline and 12 weeks after the intervention began, both groups were examined in terms of HbA1c and fasting blood glucose (FBG) as the primary outcomes, as well as variables such as blood lipid profile, blood pressure, and physical fitness-related indexes as secondary outcomes. Longitudinal glycemic control was assessed through triplicate FBG measurements extracted from standardized electronic health records at the 2-year follow-up. Independent t tests or Mann-Whitney U tests were used to assess changes from baseline to follow-up between groups.
A total of 92.7% (556/600) of the participants completed the 12-week follow-up visit. The WeChat-based intervention demonstrated superior glycemic control outcomes, with intervention participants achieving a 0.59% greater HbA1c reduction than controls (-0.03% vs 0.56%; P<.001) and significant improvements in FBG levels (-0.69 vs 0.00 mmol/L; Δ=0.69; P=.001). Subgroup analysis revealed that WeChat-based health education was significantly effective in patients with diabetes with a disease duration of <10 years, educational level of junior high school or lower, and annual family income of <CN ¥50,000 (US $7172.10) . These benefits persisted throughout the 2-year follow-up, where the intervention group maintained lower FBG levels (6.87 vs 7.35 mmol/L; P=.001).
WeChat-based health education was beneficial for glycemic control in primary health care settings. However, the sustained efficacy and feasibility of this approach require further investigation.
中国糖尿病流行情况在血糖控制方面存在重大差距，2021年接受治疗的患者中只有50.1%达到糖化血红蛋白（HbA1c）目标。传统干预措施在基层医疗中难以实现可扩展性，尤其是对弱势群体而言。
本研究旨在评估使用基于微信的健康教育工具（微信运动小程序、巴渝健康公众号和微信群聊）改善社区2型糖尿病患者血糖控制的效果。
这项多中心随机对照试验纳入了来自重庆3个社区的600名成年2型糖尿病患者，于2020年9月将参与者按1:1随机分配至为期12周的基于微信的干预组（n = 300，50%）或对照组（n = 300，50%）。对照组接受4次面对面传统健康教育课程，而干预组参与一个数字化项目：为期4周的课程，随后是8周的实际实施阶段。在基线期以及干预开始后12周，对两组进行糖化血红蛋白和空腹血糖（FBG）检查作为主要结局指标，同时将血脂谱、血压和体能相关指标等变量作为次要结局指标。通过在2年随访期从标准化电子健康记录中提取的三次空腹血糖测量值评估纵向血糖控制情况。采用独立t检验或曼-惠特尼U检验评估两组从基线到随访期间的变化情况。
共有92.7%（556/600）的参与者完成了12周的随访。基于微信的干预显示出更好的血糖控制效果，干预组参与者的糖化血红蛋白降低幅度比对照组大0.59%（-0.03%对0.56%；P <.001），空腹血糖水平也有显著改善（-0.69对0.00 mmol/L；差值 = 0.69；P = 0.001）。亚组分析显示，基于微信的健康教育对病程<10年、初中及以下文化程度、家庭年收入<5万元人民币（7172.10美元）的糖尿病患者具有显著效果。这些益处持续至2年随访期，干预组维持较低的空腹血糖水平（6.87对7.35 mmol/L；P = 0.001）。
基于微信的健康教育对基层医疗卫生机构的血糖控制有益。然而，这种方法的持续疗效和可行性需要进一步研究。
