Abstract
Background: Diabetes is a major chronic disorder that significantly impacts life expectancy and imposes substantial economic burdens on individuals and healthcare systems. Internet-based health management has emerged as an innovative approach to support diabetes care by facilitating sustainable behavioral change and improving health outcomes. Objective: This longitudinal study aims to evaluate the impact of internet-based health management on blood glucose control in type 2 diabetes (T2D) patients over four years. Methods: A total of 30,333 participants were recruited from five provinces in China in 2013, including 2307 T2D patients. Participants utilized a comprehensive internet-based health management platform that provided personalized diet plans, exercise recommendations, and psychological support. Data were collected through regular health examinations and questionnaires, and logistic regression was conducted to identify key factors associated with effective blood glucose control. Results: After four years, the diabetes awareness rate among T2D patients increased from 17.72% to 19.84%, and the control rate rose from 7.22% to 26.91%. Notable improvements were observed in health-related behaviors, including smoking cessation, increased physical activity, and healthier dietary habits, particularly in the consumption of vegetables, fruits, soybeans, and nuts. Clinical outcomes also showed significant improvement, with reductions in fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C). Key factors contributing to effective blood glucose control in T2D patients included smoking cessation, increased intake of soybeans, nuts, and fruits, and reduced sedentary time. Conclusions: Internet-based health management significantly improved blood glucose control and health behaviors in T2D patients. This study confirms the potential of internet-based health management strategies to overcome geographical and healthcare access barriers, providing evidence for diabetes care in underdeveloped regions.