Medical Education in Diabetes Management on the New Horizon: Insights From Metabolic Management Center

The global diabetes epidemic presents a formidable challenge to healthcare systems, with 529 million cases documented in 2021 and projections estimating a rise to more than 1.31 billion by 2050 [1]. Low- and middle-income countries bear a disproportionate burden, representing 80% of global diabetes cases [2]. Notably, China has the largest population living with diabetes worldwide, with over 118 million individuals affected [1], accompanied by alarmingly low rates of awareness, treatment, and control [3, 4]. Driven by rapid urbanization, an aging population, significant environmental and lifestyle shifts, and regional and socioeconomic disparities, China faces an urgent imperative to effectively address these challenges.

The National Metabolic Management Center (MMC), launched in 2016, emerged as a response to these challenges. Guided by the principle of “One Center, One Stop, One Standard,” MMC integrates cutting-edge medical equipment, evidence-based protocols and multidisciplinary collaboration to redefine diabetes management [5]. The MMC establishes a nationwide network of metabolic centers across hospitals and primary healthcare facilities in China to enhance guideline-based diabetes management. This editorial delineates MMC's development journey, emphasizing its innovations in patient care, medical education, artificial intelligence (AI)-driven precision medicine, and global contributions to metabolic health governance.

MMC's operational model revolutionizes traditional fragmented care by consolidating services into a unified center. Guided by the MMC Experts Committee, a series of standard operating procedures (SOPs) and MMC-specific guidelines have been developed to standardize the disease management. At every MMC, patients can receive one-stop care encompassing the complete spectrum of healthcare services from initial registration, diagnostic testing, clinical assessment, therapeutic prescription, to formulation of personalized follow-up strategies [6-8]. To ensure the nationwide implementation of this model, the MMC has established a four-tiered prevention and control network, comprising the MMC leading center, regional centers, county centers, and community centers. A teleconsultation and referral system for complex cases has been integrated into this network, enabling seamless communication and patient transfers across different levels of MMCs. Furthermore, the MMC leverages a health information platform based on Internet of Things (IoT) and advanced technologies to support continuous and personalized care delivery, effectively bridging the gap between hospital-based and community-based management. Central to the MMC platform are two interconnected systems: the MMC digital medical record system and the online education system.

The digital medical record system integrates comprehensive clinical phenotyping, detailed biochemical profiling, and diabetes-related complication indicators to create a real-time, multidimensional data fusion framework. Leveraging advanced AI technologies, it converts laboratory test report images into editable text, automatically extracts key data, and covers over 1000 metabolic parameters, ensuring seamless data interoperability across in- and out-of-hospital settings through IoT-enabled interfaces, including proprietary mobile applications, WeChat-based platforms, and telemedicine systems. Complementing this, MMC has developed a comprehensive online education system featuring patient education modules and clinical training programs for healthcare providers. Together, these initiatives tackle systemic challenges in China's metabolic disease management by eliminating care fragmentation through standardized protocols, improving access to specialists via telemedicine and tiered networks, ensuring adherence to clinical guidelines through continuous medical education, and expanding the capacity for diabetes education through online training programs.

To ensure real-time supervision and quality certification of MMC workflows and management standards, the MMC Experts Committee has established standardized monitoring processes and qualification systems.

The MMC initiative has pioneered the integration of AI technologies into diabetes management through three transformative applications.

The MMC network has expanded significantly, encompassing more than 2000 metabolic centers across 32 provinces, autonomous regions, and municipalities in China, and has provided care to 3 million patients with diabetes nationwide. Empowered by a proprietary health information platform supporting dynamic big data analysis and AI technology-based medical tools, the MMC network would continue to grow. Preliminary data show that under MMC management, the proportion of achieving glycated hemoglobin (HbA1c) < 7.0% in patients with diabetes surged from 22.7% to 53.2%. The rates of patients who met all three treatment targets (HbA1c < 7%, blood pressure < 140/90 mmHg, and low density lipoprotein-cholesterol < 2.6 mmol/L) nearly tripled from 7.3% to 19.8%. MMC's decade-long evolution demonstrates that standardization, digitalization, and medical education can dismantle barriers to equitable diabetes care.

By enabling global data sharing and fostering international collaboration, the MMC platform accelerates large-scale, real-world evidence generation while establishing a globally referential model for medical education. This integrated approach yields critical insights that advance our understanding of diabetes pathophysiology and treatment optimization, while simultaneously revolutionizing diabetes care training through standardized, data-driven educational frameworks that are being adopted worldwide.

The author declares no conflicts of interest.