Studying an educational intervention and its impact on health-related quality of life and fasting blood glucose levels among patients with type 2 diabetes mellitus in rural China.

Shaofan Chen, Kristina Burström, Bo Burström, Dongfu Qian

Abstract read

In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Shaofan ChenSchool of Health Policy and Management, Nanjing Medical University, No. 101 Longmian Avenue, Nanjing, 211166, China. Shaofan.chen@njmu.edu.cn.

Kristina BurströmEquity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, SE-17177, Sweden.

Bo BurströmEquity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, SE-17177, Sweden.

Dongfu QianSchool of Health Policy and Management, Nanjing Medical University, No. 101 Longmian Avenue, Nanjing, 211166, China.

Funding

Jiangsu Provincial Department of Education 2022SJYB0295

6 · The paper itself

Abstract

backgroundType 2 diabetes mellitus (T2DM) remains a major public health challenge in rural China, where healthcare access and health literacy are limited. Although primary healthcare (PHC) plays a key role in chronic disease management, evidence on the long-term effects of educational interventions in rural settings is scarce. This study, part of the initiative "Studying the Vertical Integration Strategy of Chronic Disease Service Based on Multiple Incentive Mechanisms in Rural China" (2015-2017), evaluated the impact of a structured educational intervention on fasting blood glucose (FBG) trajectories and health-related quality of life (HRQoL) among rural T2DM patients.

methodsA quasi-experimental study was conducted in two rural counties in Jiangsu Province, enrolling 784 patients (389 intervention, 395 control) from township health center registries. Over 24 months, the intervention group received bi-monthly education sessions, home visits, and enhanced provider training, while the control group received routine care. Outcomes were measured at baseline (2015) and two follow-ups (2016, 2017). FBG levels and HRQoL (assessed via EQ-5D-3 L, EQ-VAS, and Paretian Classification of Health Change [PCHC]) were analyzed using difference-in-differences (DID) models and multinomial logistic regression.

resultsAfter adjusted for potential confounding factors, the intervention group exhibited a slower FBG increase compared to controls (DID: -0.65, 95% CI: -1.13 to -0.17), despite an overall upward trend in both groups. HRQoL improvements were significant in the intervention group, with greater gains in mobility (84.7% vs. 86.0% reporting "no problems" in 2017, p < 0.001), pain/discomfort (62.3% vs. 55.4%, p < 0.001), and anxiety reduction (80.7% vs. 78.5%, p < 0.001). The PCHC analysis revealed intervention participants were 1.83 times more likely to improve (95% CI: 1.29-2.59) and had 83% lower risk of deterioration (OR: 0.17, 95% CI: 0.09-0.34) versus controls.

conclusionStructured educational interventions embedded in rural PHC systems effectively attenuated glycemic deterioration and enhanced multidimensional well-being in T2DM patients. However, continued FBG elevation signals the need for more comprehensive strategies, integrating digital tools and workforce reforms.

trial registrationISRCTN13319989 (Date: 31/07/2019).

Indexed as

Blood GlucoseDiabetes Mellitus, Type 2Patient Education as TopicQuality of LifeAgedChinaFastingFemaleHumansMaleMiddle AgedRural PopulationBlood GlucoseDiabetes careEducational interventionHealth-related quality of lifePrimary healthcareRural China

Identifiers

PMID40604789

DOI10.1186/s12913-025-13075-z

PMCPMC12225221

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.