Researchers in Taiwan tested a new way to help people with early-stage kidney damage from diabetes. They worked with 355 patients who received personalized education, exercise plans, dietary advice, and digital tools to manage their condition better. After following these patients for about two years, the team found that those who stuck with the program had better blood sugar control, lower blood pressure, and less protein in their urine—all signs that their kidneys were healthier. This suggests that having doctors, nurses, and nutritionists work together with patients can slow down kidney damage before it becomes serious.

The Quick Take

  • What they studied: Whether a team-based care program with education and lifestyle support could help people with type 2 diabetes prevent kidney damage in its early stages.
  • Who participated: 355 people with type 2 diabetes and early-stage kidney disease in Taiwan who enrolled in an integrated care program between May 2022 and September 2023.
  • Key finding: Patients who completed the program showed meaningful improvements: blood sugar levels dropped from 7.51% to 7.10%, systolic blood pressure decreased, and protein in urine (a sign of kidney stress) went down—all statistically significant improvements.
  • What it means for you: If you have diabetes and early kidney problems, working with a coordinated team of healthcare providers who help you manage diet, exercise, and medications may help protect your kidneys from further damage. However, this was studied in Taiwan, so results may vary in other settings.

The Research Details

This was a real-world study that followed 355 people with type 2 diabetes and early-stage kidney disease over approximately 20 months. Participants received a comprehensive intervention that included personalized education sessions, structured exercise programs, dietary counseling from nutritionists, and access to digital tools and multimedia resources to help them manage their condition. The research team measured various health markers at the beginning of the study and at follow-up visits to see if the program made a difference.

The intervention was designed to be holistic, meaning it addressed multiple aspects of health management rather than just prescribing medications. Patients learned how to monitor their own health, make better food choices, stay physically active, and understand their condition better. The program was delivered by a multidisciplinary team, which means doctors, nurses, dietitians, and other healthcare professionals worked together to support each patient.

This research approach is important because it reflects how healthcare actually works in real-world settings, not just in controlled laboratory conditions. By studying people who participated in an actual care program in Taiwan, researchers could see whether a team-based approach with education really helps prevent kidney disease from getting worse. This type of study is valuable because it shows whether interventions that seem good in theory actually work when patients use them in their daily lives.

This study has several strengths: it included a reasonably large group of participants (355 people), followed them for a substantial period (about 20 months), and measured multiple health markers to assess improvement. However, the study didn’t include a comparison group of people who didn’t receive the intervention, which would have made the results even stronger. The research was conducted in Taiwan, so the findings may not apply exactly the same way in other countries with different healthcare systems or populations.

What the Results Show

The most important finding was that patients who completed the program showed significant improvements in multiple health markers. Their blood sugar control improved, with HbA1c (a measure of average blood sugar over three months) dropping from 7.51% to 7.10%. This is meaningful because better blood sugar control helps prevent complications from diabetes.

Blood pressure also improved significantly. Systolic blood pressure (the top number) decreased in patients who had follow-up measurements, which is important because high blood pressure damages kidneys. Additionally, patients showed improvements in cholesterol levels and LDL-cholesterol (the ‘bad’ cholesterol), both of which are risk factors for kidney disease.

Perhaps most importantly for kidney health, albuminuria (protein in the urine, which indicates kidney stress) decreased. This is a key sign that the kidneys were being protected from further damage. All of these improvements occurred in patients who participated in the comprehensive team-based care program.

The study demonstrated that a coordinated approach involving multiple healthcare professionals was effective. The combination of personalized education, exercise management, dietary counseling, and digital tools appeared to work together to improve outcomes. The fact that improvements were seen across multiple health markers suggests that the program addressed several important aspects of diabetes and kidney disease management simultaneously, rather than focusing on just one factor.

This research aligns with previous studies showing that team-based care and patient education can improve outcomes in chronic diseases like diabetes. The findings support the growing evidence that comprehensive, multidisciplinary approaches are more effective than single-intervention strategies. The specific improvements in kidney function markers are consistent with research showing that better blood sugar and blood pressure control can slow kidney disease progression.

The study didn’t include a control group of people who didn’t receive the intervention, so we can’t be completely certain that all improvements were due to the program itself rather than other factors. Additionally, the research was conducted in Taiwan with its specific healthcare system, so results might differ in other countries. The study only followed patients for about 20 months, so we don’t know if benefits continue long-term or if they fade over time. Finally, the study doesn’t tell us which specific parts of the program (education, exercise, diet, or digital tools) were most important for the improvements.

The Bottom Line

If you have type 2 diabetes and early-stage kidney disease, ask your healthcare provider about participating in a comprehensive care program that includes education, dietary counseling, and exercise support. Working with a team of healthcare professionals rather than seeing just one doctor appears to help protect your kidneys. This recommendation has moderate confidence based on this research, though more studies comparing this approach to standard care would strengthen the evidence.

This research is most relevant for people with type 2 diabetes who have early signs of kidney disease (such as protein in their urine or slightly reduced kidney function). It may also be valuable for people with diabetes who want to prevent kidney problems from developing. Healthcare providers managing diabetes and kidney disease should consider implementing team-based care models. People with type 1 diabetes or those with advanced kidney disease should discuss with their doctors whether these findings apply to their situation.

Based on this study, meaningful improvements in blood sugar control and blood pressure typically appeared within the study period of about 20 months. However, some benefits like improved self-management skills might appear sooner, while others like reduced kidney stress may take longer to become apparent. Most people would likely see some improvements within 3-6 months of consistent participation in such a program, but full benefits may take longer.

Want to Apply This Research?

  • Track your blood sugar readings (HbA1c if available), blood pressure readings, and any urine test results showing protein levels. Record these measurements monthly or as recommended by your doctor to monitor whether the program is helping protect your kidneys.
  • Use the app to set and track three specific goals: (1) attending all scheduled education sessions or reviewing educational materials, (2) completing planned exercise sessions each week, and (3) following your personalized meal plan. Log these activities daily to build accountability and see your progress over time.
  • Create a dashboard that displays your key health metrics (blood sugar, blood pressure, weight) over time with trend lines. Set reminders for regular check-ins with your healthcare team and medication refills. Use the app to share your progress with your care team and receive feedback on your efforts.

This research describes a specific care program studied in Taiwan and should not be considered medical advice. If you have diabetes or kidney disease, consult with your healthcare provider before making any changes to your treatment plan or lifestyle. The findings suggest potential benefits of team-based care, but individual results may vary based on your specific health situation, medications, and other factors. Always work with your doctor to develop a personalized treatment plan appropriate for your condition.