[A study on health behavior interventions in individuals with impaired glucose tolerance]

Objective: To evaluate the effectiveness of a precision health behavior intervention model integrating wearable devices and standardized health education courses among community-dwelling adults with impaired glucose tolerance (IGT). Methods: This study employed a prospective, non-randomized controlled community-based intervention design. From May to December 2025, high-risk individuals with IGT, aged 35-60 years, were recruited from five pilot areas in Zhejiang Province. Those diagnosed with IGT by oral glucose tolerance testing were enrolled. Within each community, participants were frequency-matched by age and sex and allocated to either the intervention group or the control group. The intervention group received a 28-day intervention comprising continuous glucose monitoring, individualized exercise and dietary guidance, structured health education courses, and a 60-day consolidation management phase; the control group received routine community health management. Data were collected at baseline, on day 28, and on day 90. Statistical analyses were performed using t-tests, chi-square tests, generalized linear models, and repeated-measures analysis of variance. Results: A total of 1 047 high-risk individuals were screened, of whom 278 were diagnosed with IGT, and 191 participants (97 in the intervention group and 94 in the control group) completed the study. After the intervention, the rate of regular exercise in the intervention group increased from 38.10% to 41.20%, and the rate of adherence to a healthy diet increased from 40.20% to 47.40%, with statistically significant differences between groups (P<0.05). By day 90, metabolic parameters in the intervention group had improved markedly from baseline: the 2-hour postprandial plasma glucose level decreased from (9.26±0.94) mmol/L to (6.57±2.00) mmol/L, FPG decreased from (5.51±0.57) mmol/L to (5.29± 0.53) mmol/L, with significant group-by-time interaction effects (F=7.05, P=0.009; F=4.83, P=0.009). BMI decreased from (25.45±3.94) kg/m² to (24.63±3.34) kg/m², with a significant group-by-time interaction effect (F=6.34, P=0.013). Fasting insulin [(10.53±5.42) mIU/L vs. (8.96±4.67) mIU/L] and 2-hour postprandial insulin [(108.49±74.45) mIU/L vs. (63.08±55.79) mIU/L] levels also decreased significantly (group-by-time interaction effects: P=0.022 and P=0.016, respectively). Conclusions: The precision intervention model, combining wearable devices and standardized courses, effectively improved glycemic metabolic parameters and health behaviors in adults with IGT. The dynamic management pathway of "screening, assessment, individualized intervention, follow-up, and feedback adjustment" established in this study provides a preliminary implementation pathway for community-based prevention and management of prediabetes.