This study aimed to evaluate the tripartite linkage nursing model's effectiveness in prediabetic patients at risk of type 2 diabetes mellitus, assessing its impact on glycemic control, metabolic outcomes, diabetes prevention, and treatment adherence. In this retrospective cohort study, 400 patients (2020-2022) were allocated via medical record review to control (standard care) and experimental groups (tripartite model integrating hospital-community-home management). Clinical parameters (fasting plasma glucose, 2-hour postprandial glucose, glycated hemoglobin, body mass index, lipid profiles, blood pressure) were monitored at baseline and 6-month intervals over 24 months, with diabetes incidence and adherence rates concurrently evaluated. The experimental group demonstrated superior outcomes: fasting plasma glucose (5.8 +/- 0.4 vs 6.3 +/- 0.5 mmol/L, P < .01), 2-hour postprandial glucose (7.2 +/- 0.6 vs 8.1 +/- 0.7 mmol/L, P < .01), and glycated hemoglobin (5.9 +/- 0.3% vs 6.4 +/- 0.4%, P < .01) showed significant improvements versus controls. Metabolic benefits included reduced body mass index (24.1 +/- 2.1 vs 26.3 +/- 2.4 kg/m(2)), optimized lipids (low-density lipoprotein cholesterol: 2.4 +/- 0.3 vs 2.9 +/- 0.4; triglycerides: 1.3 +/- 0.2 vs 1.7 +/- 0.3 mmol/L), and blood pressure control (124 +/- 8/78 +/- 5 vs 131 +/- 10/83 +/- 6 mm Hg, P < .05). Notably, diabetes incidence decreased by 50% (7.5% vs 15.0%, P = .008) with higher adherence rates (88.4% vs 72.6%, P < .001), confirming dual efficacy in biological and behavioral outcomes. The tripartite model effectively reduces glycemic levels, improves metabolic indicators, lowers diabetes incidence, and enhances compliance, demonstrating significant clinical value for early diabetes prevention and management.