Influence of Internet-Based Health Management on Control of Blood Glucose in Patients with Type 2 Diabetes: A Four-Year Longitudinal Study

Q: What are the key findings of this study?

Internet-based health management over 4 years increased the diabetes control rate from 7.22% to 26.91% and reduced fasting blood glucose from 14.16 to 11.78 mmol/L (p<0.001) in T2D patients.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Type 2 diabetes (n=30333). Intervention: Internet-based health management platform (personalized diet plans, 12-phase exercise prescription, and psychological support) vs. Baseline pre-intervention status (2013). Primary outcome: Fasting blood glucose (FBG) and blood glucose control rate (FBG < 7.0 mmol/L) at 4 years (p=<0.001).

Q: What does this research mean for the field?

Internet-based health management significantly improves glycemic control and healthy lifestyle behaviors in patients with type 2 diabetes over a four-year period. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the four-year impact of an internet-based health management platform on blood glucose control and health-related behaviors among patients with type 2 diabetes.

Qiang Hu; Botian Chen; Lingfeng Dai; Chun Chang; Defu Ma

doi:10.3390/healthcare13050553

March 4, 2025HealthcareOpen Access

Influence of Internet-Based Health Management on Control of Blood Glucose in Patients with Type 2 Diabetes: A Four-Year Longitudinal Study

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Key result

Internet-based health management linked to a ~20 percentage point increase in diabetes control at 4 years.

P<0.001
n=30,333

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Why the study?

Diabetes imposes substantial burdens, and the impact of internet-based health management on blood glucose control over four years needed evaluation.

Does a 4-year internet-based health management program improve blood glucose control and health-related behaviors in adults with type 2 diabetes?

Key Points

To evaluate the four-year impact of an internet-based health management platform on blood glucose control and health-related behaviors among patients with type 2 diabetes.
Recruited 30,333 participants (including 2307 diagnosed with type 2 diabetes) from five provinces in China in 2013 and tracked them through 2017.
Provided an internet-based platform offering personalized diet plans, exercise recommendations, and psychological support, tracking outcomes via regular health examinations and questionnaires.
Conducted binary logistic regression analysis to identify behavioral and clinical factors associated with effective blood glucose control.
Among type 2 diabetes patients, the glycemic control rate rose from 7.22% to 26.91%, fasting plasma glucose decreased from 14.16 mmol/L to 11.78 mmol/L (p < 0.001), and the awareness rate increased from 17.72% to 19.84%.
Lipid parameters significantly improved, including decreases in total cholesterol (p < 0.001), triglycerides (p < 0.001), and LDL-C (p < 0.001), with the TC/HDL ratio dropping from 3.85 to 3.48.
Key factors linked to glycemic control included smoking cessation (OR = 1.360, 95% CI: 1.065–1.737), soybean and nut intake (OR = 1.427, 95% CI: 1.130–1.802), fruit intake (OR = 1.837, 95% CI: 1.375–2.453), and reduced sedentary time (OR = 1.768, 95% CI: 1.255–2.490).

Study Design

Type

Cohort (n=30,333)

Multicenter

Yes

Structured PICO

Does a 4-year internet-based health management program improve blood glucose control and health-related behaviors in adults with type 2 diabetes?

P

Population

30,333 petroleum enterprise employees in China (including 2,307 with type 2 diabetes at baseline, 1,630 newly diagnosed) aged >=18 years without severe heart or renal disease, followed for 4 years.

I

Intervention

Comprehensive internet-based employee health management platform ("Know My Health", "Improve My Health", "My Health Management Outcomes") providing personalized dietary plans (with dietary logging at least 2 days/week), a 12-phase progressive exercise prescription, psychological support, reassessment every 3 months, and remote support from healthcare professionals via phone calls or text messages (including follow-up calls after >1 week of platform inactivity) over 4 years.

O

Outcome

Blood glucose control rate (proportion of T2D patients achieving fasting blood glucose <7.0 mmol/L) and fasting blood glucose (FBG) levels at 4-year follow-up.surrogate

Main Result

Absolute Event Rate: 11.78% vs 14.16%

p-value: p=<0.001

A four-year internet-based health management program was associated with substantial improvements in glycemic control, lipid profiles, and healthy lifestyle behaviors among Chinese adults with type 2 diabetes.

Limitations

Targeted employees of large enterprises with a relatively high attrition rate during long-term follow-up (56,542 at baseline to 30,333 at follow-up)
Self-reported dietary information and physical activity data may introduce recall and reporting bias
Fasting blood glucose (FBG) was used as the indicator of glycemic control rather than HbA1c or continuous glucose monitoring
Unable to collect patients' medication information or account for medication adherence
Longitudinal observational design is subject to unmeasured confounding from diabetes duration, baseline health status, and socioeconomic status
Targeted employees of large enterprises with a relatively high attrition rate during the long follow-up period due to factors such as job changes
Self-reported dietary information and physical activity data may introduce bias
Rapid advancements in diabetes management tools may lead to differences between the study intervention and current technological standards
Fasting blood glucose (FBG) cannot fully reflect blood glucose fluctuations or long-term blood glucose levels, and HbA1c levels and medication information were not regularly collected
Subject to confounding factors such as differences in diabetes duration, baseline health status, and socioeconomic status

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

May improve T2D glycemic control; hypothesis-generating and requires RCTs to confirm causality before practice change.

Abstract

Background: Diabetes is a major chronic disorder that significantly impacts life expectancy and imposes substantial economic burdens on individuals and healthcare systems. Internet-based health management has emerged as an innovative approach to support diabetes care by facilitating sustainable behavioral change and improving health outcomes. Objective: This longitudinal study aims to evaluate the impact of internet-based health management on blood glucose control in type 2 diabetes (T2D) patients over four years. Methods: A total of 30,333 participants were recruited from five provinces in China in 2013, including 2307 T2D patients. Participants utilized a comprehensive internet-based health management platform that provided personalized diet plans, exercise recommendations, and psychological support. Data were collected through regular health examinations and questionnaires, and logistic regression was conducted to identify key factors associated with effective blood glucose control. Results: After four years, the diabetes awareness rate among T2D patients increased from 17.72% to 19.84%, and the control rate rose from 7.22% to 26.91%. Notable improvements were observed in health-related behaviors, including smoking cessation, increased physical activity, and healthier dietary habits, particularly in the consumption of vegetables, fruits, soybeans, and nuts. Clinical outcomes also showed significant improvement, with reductions in fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C). Key factors contributing to effective blood glucose control in T2D patients included smoking cessation, increased intake of soybeans, nuts, and fruits, and reduced sedentary time. Conclusions: Internet-based health management significantly improved blood glucose control and health behaviors in T2D patients. This study confirms the potential of internet-based health management strategies to overcome geographical and healthcare access barriers, providing evidence for diabetes care in underdeveloped regions.

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Cite This Study

Hu et al. (2025) conducted a cohort in Type 2 diabetes (n=30,333). Internet-based health management platform (personalized diet plans, 12-phase exercise prescription, and psychological support) vs. Baseline pre-intervention status (2013) was evaluated on Fasting blood glucose (FBG) and blood glucose control rate (FBG < 7.0 mmol/L) at 4 years (p=<0.001). Internet-based health management over 4 years increased the diabetes control rate from 7.22% to 26.91% and reduced fasting blood glucose from 14.16 to 11.78 mmol/L (p<0.001) in T2D patients.

synapsesocial.com/papers/6a81ac1569a8c95c3f3cc58f https://doi.org/10.3390/healthcare13050553

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Influence of Internet-Based Health Management on Control of Blood Glucose in Patients with Type 2 Diabetes: A Four-Year Longitudinal Study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Influence of Internet-Based Health Management on Control of Blood Glucose in Patients with Type 2 Diabetes: A Four-Year Longitudinal Study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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