The effects of online equipment on management of patients with type 2 diabetes

Objectives : To assess the value of National Metabolic Management Centers (MMC) specialized online equipment for the maintenance of metabolic control among patients with type 2 diabetes (T2DM). Patients : Between June 2017 and April 2021, patients with T2DM with at least one follow-up visit with HbA1c detected from 10 MMCs were enrolled and divided into non and application of online equipment (non-AOE and AOE) groups. Measurements : Propensity score matching (PSM) was used to balance the characteristics of patients between groups. The change in glycated haemoglobin (HbA1c) was used to evaluate the effect of online equipment on diabetic management. Further stratified analyses were performed to assess the metabolic outcomes in subgroups. Results : After PSM, 12528 patients with T2DM were finally enrolled. After a median (IQR) follow-up of 15.88 (7.10, 24.27) months, the AOE group showed better control of HbA1c than non-AOE group (-0.90 [-2.60, 0.00] % vs. -0.70 [-2.20, 0.10] %, P < 0.0001) and high frequency AOE group showed better control of HbA1c than low frequency AOE group (-1.50 [-3.60, -0.30] % vs. -0.80 [-2.38, 0.10] %, P < 0.0001) after adjustment. More decrease in body mass index (BMI) was observed in AOE group. Stratification analyses showed that significant between-group change in HbA1c was observed in those with lower education level or poor control of HbA1c at baseline. Conclusions : Applying online equipment promotes better metabolic improvement and offers an alternative to out-of-hospital patient care in patients with T2DM, especially with lower education level or poorer control of HbA1c at baseline.