Effect of a Web-Based Management Guide on Risk Factors in Patients With Type 2 Diabetes and Diabetic Kidney Disease:...

Area of Science:

• Nephrology
• Endocrinology
• Digital Health

Background:

• Diabetic kidney disease (DKD) management requires addressing multiple targets to prevent comorbidities.
• Technology-assisted team-based care shows promise for improving outcomes in type 2 diabetes, but its effect on DKD patients is less understood.

Purpose of the Study:

• To evaluate the impact of the Joint Asia Diabetes Evaluation (JADE) web portal, nurse reminders, and team-based care on multiple risk factors in DKD patients.

Main Methods:

• A 12-month multinational randomized trial involving 2393 DKD patients.
• Three groups: usual care, empowered care (JADE report, nurse calls), and team-based empowered care (additional physician-nurse reviews).
• Primary outcome: proportion of patients achieving at least 3 of 5 treatment targets (HbA1c, blood pressure, LDL-C, triglycerides, RAAS inhibitor use).

Main Results:

• Team-based empowered care significantly increased the attainment of multiple treatment targets compared to usual care (RR 1.17) and empowered care (RR 1.25).
• Patients achieving multiple targets had a lower incidence of cardiovascular, kidney, and cancer events (8.4% vs 14.5%).
• The team-based empowered care group showed the greatest improvement in target attainment (9.1% increase).

Conclusions:

• Technology-assisted team-based care, incorporating the JADE portal and multidisciplinary support, effectively improves multiple treatment target attainment in DKD patients.
• This intervention also enhances patient empowerment and is associated with reduced adverse clinical events.
• Findings support the integration of technology and team-based strategies for managing complex conditions like DKD.