{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:31:12Z","timestamp":1786516272466,"version":"build-2736575974"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n De-identified routine-care records were used to compare a structured nurse-led digital therapeutics pathway with usual care over 24\u202fweeks. 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 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;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), while mean glycated hemoglobin change was \u22120.8% and \u22120.3% (difference, \u22120.5 percentage points;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). 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.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1889568","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:57:15Z","timestamp":1786514235000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurse-led digital therapeutics for type 2 diabetes in routine care: a retrospective cohort study of adherence, glycemic outcomes, and care continuity"],"prefix":"10.3389","volume":"14","author":[{"given":"Jinyan","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Nephrology, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lintao","family":"Zhen","sequence":"additional","affiliation":[{"name":"Sichuan City Vocational College","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1803","DOI":"10.1016\/S0140-6736(22)01655-5","article-title":"Type 2 diabetes","volume":"400","author":"Ahmad","year":"2022","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2753","DOI":"10.2337\/dci22-0034","article-title":"Management of hyperglycaemia in type 2 diabetes, 2022: a consensus report by the American Diabetes Association and the European Association for the Study of Diabetes","volume":"45","author":"Davies","year":"2022","journal-title":"Diabetes Care"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/S0140-6736(23)01301-6","article-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the global burden of disease study 2021","volume":"402","year":"2023","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF Diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"S126","DOI":"10.2337\/dc24-S007","article-title":"7. 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