{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T18:11:50Z","timestamp":1760811110536,"version":"build-2065373602"},"reference-count":30,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72204277"],"award-info":[{"award-number":["72204277"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003785","name":"Medical Scientific Research Foundation of Guangdong Province of China","doi-asserted-by":"crossref","award":["A2023183"],"award-info":[{"award-number":["A2023183"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Medical Science and Technology Research Foundation of Guangdong Province","award":["A2022309"],"award-info":[{"award-number":["A2022309"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,17]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Individuals with pre-diabetes are at high risk for developing type 2 diabetes mellitus (T2DM), which makes them prone to serious complications such as stroke, kidney failure, blindness and lower-limb amputation. Pre-diabetes can be reversed, and lifestyle modification is considered the best intervention method for diabetes prevention. However, it is difficult for individuals with pre-diabetes to maintain a long-term modified healthy lifestyle owing to psychological burnout in daily management over time due to poor adherence. We developed a novel virtual health management community (VHMC) model based on group interaction management. We present the protocol for the VHMC model applied to the pre-diabetic population\u2014a randomised controlled trial (RCT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>This study will be conducted to determine the effectiveness of the pre-diabetes VHMC\u2013group interaction management model on improving long-term lifestyle intervention adherence to reduce the incidence of T2DM in China. We will conduct a prospective, multicentre, single-blinded, two-arm, RCT, and a total of 706 patients will be recruited. Those randomly assigned to the intervention group will receive group interaction management based on the VHMC platform. Measures of incidence of T2DM, diabetes outcomes, lifestyle modification and psychosocial outcomes will be assessed at baseline, 3, 6, 12, 24 and 36 months. If the VHMC\u2013group interaction management model shows efficacy in improving the self-management of pre-diabetes or metabolic control, similar interventions may be applied to other chronic conditions. The cost-utility analysis of this model may indicate that this platform could be a potentially cost-effective and efficient way to integrate the VHMC platform into the health management of patients with pre-diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University approved this study (No. RG2023-262-02). The results of this study will be disseminated through conference presentations and peer-reviewed publications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ChiCTR2400081268. Study start: 1 July 2024, completion: 1 December 2026.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086268","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T07:50:21Z","timestamp":1735199421000},"page":"e086268","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-diabetes virtual health management community (VHMC) intervention and group interaction management model in China: a randomised clinical trial protocol"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5849-400X","authenticated-orcid":false,"given":"Yifan","family":"Wang","sequence":"first","affiliation":[{"name":"Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiling","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology & Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China"},{"name":"Nursing Department, The Third Affiliated Hospital of Sun Yat-sen University Zhaoqing Hospital, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Cheng","sequence":"additional","affiliation":[{"name":"School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodi","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology & Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyin","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology & Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuhong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology & Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology & Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China"},{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University Zhaoqing Hospital, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"2025101810431533000_14.12.e086268.1","first-page":"1582","article-title":"Study on the incidence and influencing factors of prediabetes in Chinese adults","volume":"43","author":"Zhang","year":"2022","journal-title":"Chin J Epidemiol"},{"key":"2025101810431533000_14.12.e086268.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.m997","article-title":"Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study","volume":"369","author":"Li","year":"2020","journal-title":"BMJ"},{"key":"2025101810431533000_14.12.e086268.3","article-title":"Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia","volume":"10","author":"Richter","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2025101810431533000_14.12.e086268.4","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.tem.2017.05.005","article-title":"A Unified Pathophysiological Construct of Diabetes and its Complications","volume":"28","author":"Schwartz","year":"2017","journal-title":"Trends in Endocrinology & Metabolism"},{"key":"2025101810431533000_14.12.e086268.5","first-page":"12","article-title":"Clinical guidelines for prevention and treatment of type 2 diabetes mellitus in the elderly in China (2022 edition)","volume":"61","year":"2022","journal-title":"Chin J Endocrinol Metab"},{"key":"2025101810431533000_14.12.e086268.6","unstructured":"Intenational Diabetes Federation . 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