Integrated TCM-western "three-team" co-management for type 2 diabetes with sleep disorders: a prospective study.

BACKGROUND

Sleep disorders are common in patients with type 2 diabetes mellitus (T2DM) and are closely associated with poor glycemic control. However, evidence remains limited regarding whether an integrated traditional Chinese and Western medicine "Three-Team" co-management model can improve sleep quality and metabolic outcomes in patients with T2DM and comorbid sleep disorders.

OBJECTIVE

To evaluate the effects of an integrated traditional Chinese and Western medicine "Three-Team" co-management model on sleep quality, glycemic control, and metabolic parameters in patients with T2DM and comorbid sleep disorders.

METHODS

This prospective, concurrent, non-randomized controlled study enrolled 57 patients with T2DM and comorbid sleep disorders who attended the Department of Endocrinology of Xiamen Haicang Hospital between January and December 2025. Patients were assigned to a control group (n = 21) or an intervention group (n = 36) according to patient preference. The control group received conventional glucose-lowering therapy, whereas the intervention group received, in addition to conventional therapy, the integrated Three-Team co-management model involving an endocrinologist, a traditional Chinese medicine physician, and a health manager. The intervention lasted 6 months. Primary outcomes were the Pittsburgh Sleep Quality Index (PSQI), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c). Secondary outcomes included 2-hour C-peptide, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels. Longitudinal data were analyzed using mixed-effects linear models.

RESULTS

The intervention group showed significantly greater improvement in PSQI scores over time than the control group (group × time interaction: χ² = 32.59, P < 0.001). At 6 months, the PSQI score decreased by 2.44 points from baseline in the intervention group, representing a 2.4-fold greater reduction than in the control group. Improvements in FBG and HbA1c were also significantly greater in the intervention group (interaction P = 0.047 and P = 0.008, respectively), with significant between-group differences observed as early as 3 months (FBG difference: -2.64 mmol/L, P = 0.018; HbA1c difference: -2.09%, P = 0.002). For secondary outcomes, 2-hour C-peptide increased significantly from baseline in the intervention group (interaction P = 0.015), and reductions in TC and LDL-C were greater than those in the control group (both P < 0.05).

CONCLUSION

The integrated traditional Chinese and Western medicine "Three-Team" co-management model was associated with earlier and greater improvements in sleep quality and glycemic control in patients with T2DM and comorbid sleep disorders, with additional benefits in postprandial islet function and lipid profile.