Abstract
OBJECTIVES: To assess the value of National Metabolic Management Centers (MMC) specialized online tools, for the maintenance of metabolic control among patients with type 2 diabetes (T2DM). PATIENTS: This retrospective study enrolled T2DM patients from 10 MMCs (June 2017-April 2021) and divided into non- and application of online tools (non-AOT and AOT) groups. MEASUREMENTS: Propensity score matching (PSM) was used to balance the characteristics of patients between groups. The effect of online tools was evaluated by the change in HbA1c, with additional stratified analyses in subgroups. RESULTS: After PSM, 12528 patients with T2DM were followed for a median of 15.88 (7.10, 24.27) months, the AOT group demonstrated better control of HbA1c (-0.90 [-2.60, 0.00] % vs. -0.70 [-2.20, 0.10] %, p < 0.0001), and a greater reduction in body mass index (-0.34 ± 1.68 kg/m(2) vs. -0.13 ± 1.55 kg/m(2), p < 0.0001) and Visceral fat area (VFA) (-5.33 ± 30.95 cm(2) vs. -3.97 ± 26.11 cm(2), p = 0.009), compared to the non-AOT group, and the high-frequency AOT group achieved a more significant HbA1c reduction than the low-frequency AOT group (-1.50 [-3.60, -0.30] % vs. -0.80 [-2.38, 0.10] %, p < 0.0001) and a greater reduction in VFA (-7.07 ± 30.32 cm(2) vs. -4.90 ± 31.10 cm(2), p = 0.010) after adjustment. Stratification analyses revealed greater HbA1c reductions in those with younger age, lower education level or poor HbA1c control at baseline. CONCLUSIONS: MMC online tools significantly improve metabolic outcomes, particularly for T2DM patients with younger age, lower education levels or poor baseline HbA1c control. They offer a scalable and effective model for out-of-hospital diabetes care.