Understanding Artificial Pancreas Systems: Results from a 24-Month Trial

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The intervention group experienced a significantly greater reduction of 0.42% compared to the control group (95% CI 0.12%-0.73%).

HbA1c decreased more in the intervention group over 6 months than in the control group, although the detailed model output showed a borderline group-by-time result at 6 months.

Change in 6 months: intervention group 5.88 (95% CI 4.98 to 6.79); control group -0.11 (95% CI -1.34 to 1.14).

Diabetes self-management behavior scores improved more in the intervention group than in the control group at 6 months.

Change in 6 months: intervention group 9.40 (95% CI 8.15 to 10.66); control group 0.05 (95% CI -0.49 to 0.59).

Self-efficacy scores increased substantially in the intervention group and showed little change in the control group at 6 months.

Change in 6 months: intervention group 19.54 (95% CI 17.71 to 21.36); control group 5.52 (95% CI 4.43 to 6.60).

Health belief scores increased more in the intervention group than in the control group, reflecting stronger diabetes-related health beliefs after the program.

No serious adverse clinical events were reported from enrollment to the 6-month follow-up.

No serious adverse clinical events were reported during the 6-month follow-up, but safety reporting was brief.

A multicomponent home telemedicine and HBM-based education program delivered by a multidisciplinary team to support glucose monitoring, medication guidance, diet and exercise planning, and diabetes self-management.

Positive: 4; Negative: 0; No effect: 1; Mixed: 0

Extracted 5 outcome signals across the study

HbA1c and all reported behavioral secondary outcomes favored the intervention, while safety reporting found no serious clinical adverse events but was limited.

HbA1c ↓ more with telemedicine plus HBM education than with routine community management at 6 months

Diabetes self-management behaviors ↑ in the intervention group compared with control

Mostly intermediate or surrogate outcomes

Participants were randomly assigned to intervention or control groups, with 99 participants in each group.

The intervention lasted 6 months and included telemedicine smart devices, glucose monitoring, multidisciplinary feedback, and HBM-based education.

The intervention group had greater improvements in HbA1c, SDSCA, SED, and HBM scores at 6 months.

Zhang A, Wang J, Wan X, et al. Community-Based Intelligent Blood Glucose Management for Older Adults With Type 2 Diabetes Based on the Health Belief Model: Randomized Controlled Trial. JMIR Mhealth Uhealth. 2025;13:e60227. doi:10.2196/60227

The trial lasted 6 months, so long-term effects are unknown.

Participants willing to join may have had higher readiness for digital health tools.

Several secondary outcomes were questionnaire-based and may be affected by recall bias.

The care providers delivering the intervention were not blinded.

A 6-month randomized trial found that home telemedicine plus Health Belief Model education improved HbA1c and self-management outcomes in older adults with type 2 diabetes.

Self-efficacy and health belief scores ↑ more in the intervention group

Participants self-measured blood sugar at least twice weekly; alerts triggered physician contact; group education occurred every 2 weeks for 3 months.

Home telemedicine intervention with HBM-based health education

Routine community-based diabetes management was implemented, including a free health consultation yearly and random blood glucose testing every 3 months.

Routine community-based diabetes management

Includes self-reported outcomes (moderate): Self-reported outcomes used

Limited population scope (moderate): Narrow population scope

Limited safety reporting (moderate): Safety reporting depth: limited

No post-intervention follow-up (moderate): 0 weeks of follow-up after treatment ended

Home telemedicine may improve HbA1c in older adults with type 2 diabetes

This randomized trial tested a home telemedicine program combined with Health Belief Model-based education in older adults with type 2 diabetes. After 6 months, the intervention group had better HbA1c improvement and higher self-management, self-efficacy, and health belief scores than the control group.

This was not a medication trial; the intervention was digital monitoring plus education and care-team support.

The control group also received routine community diabetes management and diabetes handbooks.

Technology setup issues were reported, including Bluetooth pairing inconvenience.

The strongest evidence is for short-term changes over 6 months.

A home telemedicine and HBM education program for older adults with type 2 diabetes.

Home telemedicine may improve HbA1c in older adults with type 2 diabetes

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