Diabetic kidney disease (DKD) is a major complication of type 2 diabetes and can lead to serious health issues if not managed properly. A recent randomized clinical trial conducted in 13 hospital-based diabetes centers in 8 countries has found that technology-assisted team-based care can improve patient outcomes by reducing multiple risk factors in patients with DKD.
The trial involved 2,393 patients with DKD who were randomized to usual care, empowered care, or team-based empowered care. All patients underwent a Joint Asia Diabetes Evaluation (JADE) web portal–guided structured assessment at baseline and month 12. Patients in the usual care and empowered care groups received a medical follow-up.
Patients in the empowered care group also received a personalized JADE report and nurse telephone calls every 3 months. Patients in the team-based empowered care group received additional face-to-face reviews every 3 months from a physician-nurse team.
The primary outcome of the trial was the proportion of patients who attained multiple treatment targets, defined as achieving at least 3 of 5 targets:
HbA1c level <7.0% [53 mmol/mol]
blood pressure <130/80 mm Hg
low-density lipoprotein cholesterol level <1.8 mmol/L
triglyceride level <1.7 mmol/L, and/or
persistent use of renin-angiotensin-aldosterone system inhibitors.
The team-based empowered care group had the highest proportion of patients who achieved further improvement in the attainment of multiple treatment targets, compared to the usual care and empowered care groups. The team-based empowered care group was also more likely to attain multiple treatment targets than the usual care group and the empowered care group.
Patients who attained multiple treatment targets reported a lower incidence of cardiovascular, kidney, and cancer events, further emphasizing the importance of achieving multiple treatment targets.
These findings suggest that technology-assisted team-based care can improve patient empowerment and decrease multiple risk factors in patients with DKD. The JADE web portal, nurse reminders, and team-based care can provide patients with regular feedback and support, leading to better patient outcomes.
Patients with type 2 diabetes should be aware of the importance of managing their condition, particularly in relation to preventing DKD and its comorbidities. Technology-assisted team-based care can provide patients with the necessary tools and support to achieve multiple treatment targets, ultimately leading to improved patient outcomes and quality of life.
The findings from this trial provide strong evidence that data-driven, team-based care improves patient empowerment and decreases multiple risk factors in patients with DKD. This trial highlights the importance of technology-assisted team-based care in the management of DKD and its comorbidities, emphasizing the need for ongoing support and regular feedback to achieve optimal patient outcomes.