Effectiveness of multidisciplinary glycemic management program
| ISRCTN | ISRCTN96663704 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN96663704 |
| Sponsor | Jinsha County People's Hospital |
| Funder | The Science and Technology Fund Project of Guizhou Provincial Health Commission (gzwkj2025-576) |
- Submission date
- 16/09/2026
- Registration date
- 16/09/2026
- Last edited
- 16/09/2026
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Nutritional, Metabolic, Endocrine
Plain English summary of protocol
Background and study aims
Informatics-supported hospital-wide glycemic management improves inpatient glucose control, but evidence from primary hospitals and postdischarge outcomes remains limited. This study evaluated a virtual ward-based multidisciplinary glycemic management program for orthopedic inpatients with type 2 diabetes.
Who can participate?
Orthopedic inpatients with type 2 diabetes
What does the study involve?
Consecutive eligible patients admitted between January and December 2024 constituted the control group and received usual ward-based glycemic management. Patients admitted between January and December 2025 constituted the intervention group and received the virtual ward-based program.
What are the possible benefits and risks of participating?
This transformation shifts abnormal blood glucose management from passive, sequential responses to active identification and preemptive intervention based on real-time data, substantially shortening clinical response time. Integrating online trend analysis with an initial offline bedside assessment provides a dual safeguard for precise blood-glucose management.The informatized glycemic management program yields effects beyond behavioral and knowledge gains, extending into psychosocial domains and enabling patients to convert behavioral improvements into both physical and mental benefits. Hospital-wide informatization of glycemic management can optimize medical resource allocation by reducing both length of stay and the incidence of severe hypoglycemia.
intensive glucose-lowering therapy raises the risk of hypoglycemia, and balancing effective glycemic control with safety is the central challenge of perioperative glucose management.
Where is the study run from?
It was conducted in the orthopedic department of a hospital classified as a primary hospital under China’s hospital accreditation system.
When is the study starting and how long is it expected to run for?
This study started on January 1, 2024 and lasted for 2 and a half years.
Who is funding the study?
This study was supported by the Science and Technology Fund Project of Guizhou Provincial Health Commission (gzwkj2025-576).
Who is the main contact?
Dr Fuyan Zhang, zhangfuyan2026@163.com
Contact information
Principal investigator, Public, Scientific
Yangdeng Community, Xiluo Street, Jinsha County
Bijie City
551800
China
 ORCID ID |
0009-0004-4321-9966 |
|---|---|
| Phone | +86 551800 |
| Zhangfuyan2026@163.com |
Study information
| Primary study design | Interventional |
|---|---|
| Allocation | Non-randomized controlled trial |
| Masking | Open (masking not used) |
| Control | Active |
| Assignment | Parallel |
| Purpose | Supportive care, Treatment |
| Scientific title | Effectiveness of a virtual ward-based informatics multidisciplinary glycemic management program for hospitalized diabetic patients in the orthopedic department of a primary hospital: a quasi-experimental study |
| Study objectives | This study evaluated a virtual ward-based multidisciplinary glycemic management program for orthopedic inpatients with type 2 diabetes. |
| Ethics approval(s) |
Approved 08/05/2024, The Ethics Committee of Jinsha County People's Hospital (Yangdeng Community, Xiluo Street, Jinsha County, Bijie City, 551800, China; +86-8577216115; Zxying_xyz89@21cn.com), ref: No. Ethical Review [2024] No. 38 |
| Health condition(s) or problem(s) studied | Orthopedic inpatients with type 2 diabetes |
| Intervention | A nonrandomized, non-concurrent, controlled quasi-experimental design. The control group received usual ward-based glycemic management. The intervention group received a virtual ward-based multidisciplinary glycemic management program. The intervention consisted of four integrated components: staff training, a hospital-wide glycemic management platform, multidisciplinary clinical management, and structured post-discharge follow-up. Training was coordinated by senior endocrinologists and endocrinology nurse leaders and was tailored to the responsibilities of different staff groups. The hospital-wide glycemic management platform received and synchronized bedside glucose measurements with authorized nursing and medical workstations. A pre-meal glucose value above 7.8 mmol/L or a 2-hour postprandial value above 10.0 mmol/L generated an orange alert and prompted assessment for virtual ward enrollment and endocrinology review. Patients remained admitted to the orthopedic department while receiving additional specialist support through the virtual ward. Endocrinologists reviewed system alerts and conducted an initial bedside assessment of patients enrolled in the virtual ward. Treatment plans were subsequently adjusted according to glucose trends and the patient's clinical condition. Endocrinology specialist nurses reviewed glucose measurements and trends and provided individualized bedside education once daily. Orthopedic nurses performed prescribed bedside glucose monitoring, administered glucose-lowering treatment, reinforced education on medication, diet, exercise, and self-monitoring, and checked the operation of connected devices used in the orthopedic ward. Diabetes liaison nurses supported implementation of the management protocol within the orthopedic department. Dietitians provided staged perioperative nutritional recommendations based on clinical status and glucose patterns. Information technology personnel were solely responsible for maintaining the platform, connected devices, data transmission, system security, and technical support. Before discharge, endocrinology specialist nurses developed an individualized management plan and instructed patients in the use of a connected home glucose meter. Follow-up was conducted through the platform every 2 weeks for 3 months. |
| Intervention type | Behavioural |
| Primary outcome measure(s) |
|
| Key secondary outcome measure(s) |
1. Number of hyperglycemic and hypoglycemic glucose measurements measured using blood glucose measurements during hospitalization, with hyperglycemia defined as a premeal glucose value >7.8 mmol/L or a 2-hour postprandial glucose value >10.0 mmol/L, and hypoglycemia defined as a glucose value <3.9 mmol/L, during hospitalization |
| Completion date | 30/06/2026 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 18 Years |
| Upper age limit | 80 Years |
| Sex | All |
| Target sample size at registration | 254 |
| Total final enrolment | 254 |
| Key inclusion criteria | 1. Aged 18 years or older 2. Met the diagnostic criteria for type 2 diabetes specified in the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes 3. Had an expected hospital stay of at least 3 days 4. Possessed adequate cognitive ability to complete the questionnaires independently or with assistance 5. Provided written informed consent |
| Key exclusion criteria | 1. Had non-type 2 diabetes (e.g., type 1 diabetes or other specific types of diabetes) 2. Presented with severe acute diabetic complications (e.g., diabetic ketoacidosis or hyperosmolar hyperglycaemic state) 3. Suffered from severe end-stage organ dysfunction, including: 3.1. Cardiac failure 3.2. Hepatic failure 3.3. Renal failure 4. Had terminal-stage malignancy 5. Withdrew consent 6. Was discharged against medical advice 7. Was transferred to another department during the index hospitalisation 8. Was lost to follow-up during the 3-month post-discharge period |
| Date of first enrolment | 01/01/2024 |
| Date of final enrolment | 31/12/2025 |
Locations
Countries of recruitment
- China
Study participating centres
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|
Editorial Notes
16/09/2026: Trial's existence confirmed by The Ethics Committee of Jinsha County People's Hospital.
