Online co-care management and glycemic control in patients with type 2 diabetes mellitus: A propensity score-matched retrospective cohort study

OBJECTIVE: This study aimed to investigate the association of an Online Co-care Management (OCCM) model with changes in glycemic control and metabolic indicators among patients with type 2 diabetes mellitus (T2DM). METHODS: Based on clinical follow-up records, we conducted a retrospective cohort study with a propensity score (PS)-matched control group.The OCCM group included patients enrolled in the integrated care clinic from 2022 to 2025 (n = 406). Among patients who did not participate in OCCM (n = 199) during the study period, PS-matched controls were selected at a 1:1 ratio.The PS model included age, sex, diabetes duration, smoking, drinking, medication use, and follow-up duration.After matching, 240 patients were included in the final analysis, with 120 patients in each group. Follow-up data were collected at baseline, 3 months, and 6 months. Longitudinal data on anthropometrics, glycemic indices, blood pressure, lipid profiles, and organ function were analyzedusing repeated measures ANOVA. RESULTS: Over a 6-month follow-up period, HbA1c levels decreased more markedly in the OCCM group compared with the usual-care group. In the OCCM group, HbA1c declined from 7.403 ± 1.748% at baseline to 6.591 ± 0.871% at 3 months and 6.593 ± 1.056% at 6 months, while in the usual-care group, it changed from 6.310 ± 1.277% to 6.225 ± 1.017% and 6.534 ± 1.598%, respectivelyRepeated-measures ANOVA revealed significant time, group, and time × group effects for HbA1c (F = 10.608, P < 0.001; F = 16.748, P < 0.001; F = 14.546, P < 0.001). BMI, systolic and diastolic blood pressure, and lipid profiles, also showed greater improvements in the OCCM group than in controls. CONCLUSION: The OCCM model was associated with short-term improvements in glycemic and metabolic indicators among T2DM patients, suggesting it may be an effective approach for structured chronic disease management.