ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
The impact of a value-based hospital-community-family linkage program on blood glucose management and hypoglycemia in elderly diabetic patients: A randomized controlled trial
Provisionally accepted
- 1Nanjing University of Chinese Medicine, Nanjing, China
- 2Institute of Clinical Medicine, Taizhou People’s Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Taizhou, China
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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 Sixth People's Hospital of Zhangjiagang City 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-month 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.
Keywords: Elderly, Diabetes Mellitus, Blood Glucose, Hypoglycemia, personalized health management
Received: 30 Jun 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Zhuang, Ding, Yu, Wang, Chen and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hao Wu, haowu-hw@outlook.com
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