The impact of a value-based hospital-community-family linkage program on blood
glucose management and hypoglycemia in elderly diabetic patients: a randomized
controlled trial
#MMPMID41346986
Zhuang X
; Ding H
; Yu F
; Wang M
; Chen Y
; Wu J
Front Med (Lausanne)
2025[]; 12
(?): 1656364
PMID41346986
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TRIAL DESIGN: The management of elderly type 2 diabetes (T2DM) presents
significant challenges, with the risk of hypoglycemia being particularly
prominent. This risk severely impacts patients' quality of life and health
outcomes. This study aims to evaluate the impact of a hospital-community-family
linkage program based on value-based medicine principles and integrated with
information technology on blood glucose management and hypoglycemic events in
elderly T2DM patients. METHODS: This study was a randomized controlled trial
conducted between September 2023 and September 2024. A total of 254 elderly
patients with T2DM admitted to the Zhangjiagang Sixth People's Hospital were
randomly assigned to either the linkage program group (n = 138) or the
conventional management group (n = 116). The linkage program group received a
6-months structured intervention that integrated personalized health management
records, regular follow-ups conducted through telemedicine platforms, and
community education facilitated by digital tools. The conventional management
group received standard health education, dietary guidance, and medication
advice. The primary outcome measure was the incidence of hypoglycemic events.
Secondary outcomes included fasting plasma glucose (FPG), 2-hour postprandial
glucose (2hPG), self-efficacy in diabetes management, average daily dose of
antidiabetic medications, and anxiety levels. RESULTS: The linkage program group
demonstrated significant reductions in the average number of hypoglycemic events
(3.81 vs. 4.13, P = 0.015) and required lower doses of antidiabetic medications.
Improvement in fasting plasma glucose (6.93 vs. 7.46 mmol/L, P = 0.013) was
observed. In addition, participants reported reduced anxiety levels (88.41% low
anxiety vs. 73.28%, P = 0.005). CONCLUSION: The value-based
hospital-community-family linkage program significantly enhanced blood glucose
management and reduced hypoglycemic events in elderly T2DM patients. These
results indicate the significant benefits of informatization in blood glucose
management and highlight its potential for broader implementation in clinical
practice to enhance patient outcomes.
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