Effectiveness of internet-based management in newly diagnosed young adults with type 2 diabetes: a prospective comparative study

Abstract

Background: The incidence of type 2 diabetes mellitus (T2DM) is rising among young adults, posing challenges for long-term management after discharge.

Methods: 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).

Results: 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).

Conclusion: The internet-based management system with personalized feedback significantly improved glycemic control and quality of life in young adults with T2DM.

Keywords: glycemic control; internet-based management; personalized feedback; type 2 diabetes; young adults.

Figure 1

Changes in glycemic, metabolic, renal and cardiovascular parameters over time. Dynamic changes in key clinical parameters, including glycemic control, lipid profiles, renal function and blood pressure, are shown for the intervention and control groups over the 12-month follow-up period. Data are presented as the means ± SEM, and statistical significance for group differences at each time point is denoted by *P < 0.05 and **P < 0.01, as determined by repeated measures ANOVA. (A) HbA1c, glycated hemoglobin; (B) TC, total cholesterol; (C) fasting C-peptide levels with adjusted significance positions; (D) FBG, fasting blood glucose; (E) TG, triglycerides; (F) UACR, urinary albumin-to-creatinine ratio; (G) HOMA-IR, homeostasis model assessment of insulin resistance; (H) LDL-C, low-density lipoprotein cholesterol; (I) SBP, systolic blood pressure; (J) HOMA-β, homeostasis model assessment of β-cell function; (K) HDL-C, high-density lipoprotein cholesterol; (L) DBP, diastolic blood pressure.