Abstract
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.