Glycemic Control of Type 2 Diabetes with the Chinese Metabolic Management Center and eKTANG

Objective . Long-term management of patients with type 2 diabetes is a challenging clinical problem. The Metabolic Management Center (MMC) has been implemented in China to address metabolic diseases. This study aimed to evaluate the effectiveness of combining MMC with the eKTANG App, which is a fee-based blood glucose-monitoring platform, to improve outcomes for patients with diabetes. Methods . We recruited 240 patients with type 2 diabetes to our randomized controlled trial; the patients were randomly assigned into a control group (n = 120) and an intervention group (n = 120). Participants in the control group received MMC management; those in the intervention group received MMC + eKTANG management. Serum samples were taken at 0, 3, 6, and 12 months to test liver and kidney function, blood lipids, uric acid, and blood glucose-related indicators. An oral glucose tolerance test and behavior questionnaires were administered and complications related to type 2 diabetes were noted at 0, 6, and 12 months. Results . After up to 12 months of intervention with MMC + eKTANG, patients had improved mean (SEM) concentrations of hemoglobin A1c (6 months: control, 7.09% [1.32%] vs intervention, 7.19% [3.50%]; 9 months: control, 6.33% [0.31%] vs intervention, 6.50% [1.00%]; 12 months: control, 6.31% [2.30%] vs intervention, 6.01% [2.30%]), fasting plasma glucose (9 months: control, 7.20 [2.35] mmol/L vs intervention, 7.01 [0.56] mmol/L; 12 months: control, 6.98 [0.03] mmol/L vs intervention, 6.24 [2.03] mmol/L), and 2-hour postprandial plasma glucose (9 months: control, 9.85 [0.34] mmol/L vs intervention, 9.50 [0.23] mmol/L; 12 months: control, 9.55 [0.25] mmol/L vs intervention, 8.68 [0.87] mmol/L). The mean (SEM) concentrations of insulin and C-peptide measured during the oral glucose tolerance test also improved (measured as incremental area under the curve 0-180 min glucose; 6 months: control, 360.25 [2.30] mmol/Lxmin vs intervention, 352.24 [0.89] mmol/L x min; 12 months: control, 332.01 [2.32] mmol/L x min vs intervention, 300.32 [0.78] mmol/L x min). Moreover, the intervention ameliorated markers of lipid metabolism and liver and kidney function, and complications and behaviors related to diabetes. Conclusion . The MMC + eKTANG intervention combines the convenience and efficacy of the internet for delivering timely medical care and guidance to individuals with diabetes with valuable information for managing diabetes in daily life. This innovative approach incorporates a fee-based system to enhance patient motivation and initiative, leading to a novel and effective perspective on diabetes management beyond traditional hospital settings.