Nurse-led digital therapeutics for type 2 diabetes in routine care: a retrospective cohort study of adherence, glycemic outcomes, and care continuity.

BACKGROUND

Digital therapeutics can extend diabetes self-management beyond clinic visits, but sustained engagement, safe interpretation of patient-generated data, and integration with routine care remain challenging.

OBJECTIVE

This study examined the real-world association between a nurse-led digital therapeutics pathway and clinical, behavioral, and patient-experience outcomes among adults with type 2 diabetes.

METHODS

De-identified routine-care records were used to compare a structured nurse-led digital therapeutics pathway with usual care over 24 weeks. Eligible baseline records were classified by documented routine-care pathway exposure, and outcome analyses used complete 24-week records. The nurse-led pathway included digital readiness assessment, onboarding education, adherence monitoring, tiered follow-up, feedback reports, and coordination with physicians and technical staff.

RESULTS

Complete 24-week data were available for 57 patients in the nurse-led pathway and 56 receiving usual care. Adherence was 78.3% and 54.7%, respectively (between-pathway difference, 23.6 percentage points; p < 0.001), while mean glycated hemoglobin change was -0.8% and -0.3% (difference, -0.5 percentage points; p < 0.001). The nurse-led pathway was also associated with higher PSQ-18 satisfaction scores, better self-management behavior, and lower glycemic variability. Pathway exposure remained the strongest factor associated with adherence after adjustment.

CONCLUSION

In this single-center retrospective cohort, the nurse-led digital therapeutics pathway was associated with more sustained digital engagement and more favorable metabolic and patient-reported outcomes than usual care. Prospective multicenter studies are needed before causal or broad implementation claims can be made.