Research Article: Long-term glycemic outcomes of a diabetes management platform in a traditional Chinese medicine hospital: a real-world retrospective observational study
Abstract:
Sustained glycemic control in type 2 diabetes mellitus (T2DM) remains difficult in routine care. Long-term real-world evidence on diabetes management platforms in Traditional Chinese Medicine (TCM) hospitals is limited.
We conducted a real-world retrospective observational study at Guangdong Provincial Hospital of Traditional Chinese Medicine. Adults with T2DM enrolled in a hospital-based chronic disease management platform between January 2017 and December 2018 were followed for up to 36 months. Primary outcomes were longitudinal changes in glycated hemoglobin (HbA1c) and HbA1c target attainment (<7.0%). Secondary outcomes included fasting blood glucose (FBG), postprandial blood glucose (PBG), body mass index (BMI), and self-reported lifestyle and self-management behaviors. Linear mixed-effects models and generalized estimating equations were used for longitudinal analyses.
A total of 546 patients were included. HbA1c decreased significantly over 36 months, and the proportion achieving HbA1c <7.0% increased from 30% at baseline to 49% at 12 months and remained around 45% at 24 and 36 months. Patients with baseline HbA1c >9.0% showed the greatest absolute reductions, whereas those with baseline HbA1c <7.0% generally maintained near-target levels. Clinically meaningful HbA1c reductions were common among participants with paired measurements, and sustained HbA1c target attainment was also observed across follow-up visits. In contrast, longitudinal changes in FBG were not significant, while reductions in PBG and BMI were modest. Improvements in lifestyle and self-management behaviors were limited.
In this TCM hospital setting, platform-based chronic disease management was associated with sustained improvement in HbA1c over 3 years. Greater benefit was observed in patients with poor baseline glycemic control, although improvements in behavioral indicators and other metabolic measures were limited.
Introduction:
Sustained glycemic control in type 2 diabetes mellitus (T2DM) remains difficult in routine care. Long-term real-world evidence on diabetes management platforms in Traditional Chinese Medicine (TCM) hospitals is limited.
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