Structured case management may improve recovery after CABG in older adults with type 2 diabetes
Key Takeaway:
In a 6-month randomized trial of 168 elderly patients with type 2 diabetes after off-pump CABG, structured multidisciplinary case management improved cardiac function, HbA1c, walking distance, lipids, and quality-of-life outcomes versus routine care.
Study at a Glance
What was studied
A 6-month multidisciplinary case management program after off-pump CABG in older adults with type 2 diabetes
Study Type
Randomized Controlled Trials (RCTs)
duration
Medium-Term (3–12 mo)
Intervention
Multidisciplinary case management program
Outcomes
Left ventricular ejection fraction (LVEF), HbA1c, 6-minute walk distance, Left ventricular systolic diameter, Left ventricular end-diastolic diameter, Triglycerides, Total cholesterol, LDL cholesterol, HDL cholesterol, Quality of life, Activities of daily living, Serious adverse events incidence
Funding
Non-Industry Sponsored
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Main Effects
Structured case management ↑ left ventricular ejection fraction at 6 months
Structured case management ↓ HbA1c, triglycerides, total cholesterol, and LDL cholesterol
Structured case management ↑ walking distance, quality of life, and daily living scores
Evidence Summary
| Intervention | Outcome | Measured Change | Study Effect |
|---|---|---|---|
 Structured multidisciplinary case management (Behavioral & Lifestyle) |  6-minute walk distance (Clinical Outcomes) | Increase | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) |  Activities of daily living (Patient-Reported) | Increase | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) |  HbA1c (Glycemic Control) | Decrease | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) |  HDL cholesterol (Metabolic Health) | Increase | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) | LDL cholesterol (Metabolic Health) | Decrease | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) | Left ventricular ejection fraction (LVEF) (Metabolic Health) | Increase | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) | Left ventricular end-diastolic diameter (Metabolic Health) | Decrease | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) | Left ventricular end-systolic diameter (Metabolic Health) | Decrease | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) | Quality of life (Patient-Reported) | Increase | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) | Total cholesterol (Metabolic Health) | Decrease | Strong |
Structured multidisciplinary case management (Behavioral & Lifestyle) | Triglycerides (Metabolic Health) | Decrease | Strong |
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Evidence Suggest
- The primary endpoint, LVEF change, improved by 6.2 percentage points versus routine care
- HbA1c improved by 1.3 percentage points and multiple lipid outcomes also favored the intervention
- Functional and patient-reported recovery outcomes improved while serious adverse events were similar between groups
Who this applies to
Older adults aged 65 years or above
Keep in Mind
The intervention was multi-component, so the study cannot isolate which component mattered most
Between the Lines
- Single-center study in a tertiary hospital in Tianjin
- Participants and care teams were not blinded to the intervention
- The population was selected as relatively low-risk for rehabilitation, which may limit generalizability
- Follow-up lasted 6 months, so longer-term cardiovascular outcomes remain uncertain
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Journal Reference
Zhai W, Yu H, Li Y, Zhang L, Li Q. Improved cardiac function and glycemic control in elderly diabetic patients through structured case management after CABG. Med Sci Monit. 2026;32:e952109. doi:10.12659/MSM.952109
Connected Evidence
Discover how this study fits into the broader diabetes evidence landscape.
This study contributes to evidence on DSMES Programs and Physical Function and Fitness, DSMES Programs and Quality of Life.
Related evidence relationships
Explore in Evidence ArchiveThis study contributes to the evidence on the following intervention–outcome relationships.
Included in these evidence collections
Curated evidence collections and hubs this study is part of.
DSMES Programs Evidence Hub
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Contributes to DSMES Programs evidence base.
Lipid Profile Evidence Hub
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Measures Lipid Profile as a key outcome.
Physical Function and Fitness Evidence Hub
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Measures Physical Function and Fitness as a key outcome.
Quality of Life Evidence Hub
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Measures Quality of Life as a key outcome.
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All studies on Structured multidisciplinary case management and 6-minute walk distance
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All studies on Structured multidisciplinary case management
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All studies measuring 6-minute walk distance
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All studies measuring Activities of daily living
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Questions this evidence helps answer
Key clinical and research questions this study contributes to.
Does structured multidisciplinary case management improve 6-minute walk distance?
Based on connected evidence for Structured multidisciplinary case management and 6-minute walk distance.
Does structured multidisciplinary case management affect Activities of daily living in people with diabetes?
Exploring evidence on Structured multidisciplinary case management and Activities of daily living outcomes.
What does the evidence say about structured multidisciplinary case management and HDL cholesterol?
Review of studies examining Structured multidisciplinary case management and HDL cholesterol.
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