Table 1 Intervention plan of the the stratified support pattern-based internet-assisted self-management therapy for DM-MCI

High cognition, high management

1. Monitor fasting blood glucose or 2 h postprandial blood glucose 2–3 times a week and provide once a week reminders

2. Learn disease and health-related information and assess diet, exercise, medication, cognitive training, and mental health, once a week

3. Exercise 3 days a week for 20-–40 min each time and provide once a week reminders

Dietary management: Mediterranean cuisine, with Omega-3 as the core; Use more fruits and vegetables, fish, olive oil, nuts, beans, and coarse grains. Peanut oil, soybean oil, walnut oil and rapeseed oil can be selected as oil; Fish: Both marine and non marine fish are acceptable; It is not recommended to supplement Vitamins B, E, and complex vitamins to delay cognitive impairment. Recommend low GI foods to control or reduce weight

Exercise management: 150 min of light to moderate aerobic exercise per week

Medication management: Medication time, medication method, and medication contraindication

Blood glucose monitoring: Oral hypoglycemic drugs are used to monitor fasting blood glucose or 2-h postprandial blood glucose 2–4 times a week. If blood glucose control is stable, the interval can be flexibly adjusted, and blood glucose measurement methods (Preprandial blood glucose, pre—post blood glucose matching) can be selected based on one's own blood glucose situation. Those who do not meet the standard for glycated hemoglobin should be tested every 3 months, and once every 6 months after reaching the standard

Cognitive guidance: Knowledge of cognitive impairment diseases, prevention methods, influencing factors and so on. And appropriate reminders as cognitive stimulation. Cognitive monitoring is followed up every 12 weeks

High cognition, low management

1. Monitor fasting blood glucose or 2 h postprandial blood glucose 3 × a week and provide once a week reminders

2. Learn disease and health related knowledge and assess diet, exercise, medication, cognitive training, and mental health, twice a week

3. Exercise 3 days a week for 20–40 min and provide once a week reminders

Low cognition, high management

1. Monitor fasting blood glucose or 2 h postprandial blood glucose 3 × a week and provide twice a week reminders

2. Learn disease and health-related knowledge and assess diet, exercise, medication, cognitive training, and mental health 3 × a week

Low cognition, low management

1. Monitor fasting blood glucose or 2 h postprandial blood glucose 2–3 times a week and provide 3 × a week reminders

2. Provide correct disease-related knowledge and assess diet, exercise, medication, cognitive training, and mental health twice a week

3. Exercise 3 days a week for 20–40 min and provide 3 × a week reminders

Target range of blood glucose

The target of blood sugar control is divided into three levels: strict, general, loose

The FBS is sequentially controlled as follows: 4.4–6.1 mmol/L, 6.1–7.8 mmol/L, 7.8–10.0 mmol/L

The PBS is sequentially controlled as follows:: 6.1–7.8 mmol/L,7.8–10.0 mmol/L,7.8–13.9 mmol/L

Requirements of blood sugar control

① Strict control: Before and after elective or emergency fine surgery (such as plastic surgery)

② General control: People at high risk of cardiovascular and cerebrovascular diseases accompanied by unstable cardiovascular and cerebrovascular diseases, glucocorticoid therapy, selective large, small, and organ transplant surgeries, emergency organ transplant surgeries, surgical ICU patients

③ Loose control: People at high risk of hypoglycemia, hospitalized due to cardiovascular and cerebrovascular diseases, moderate to severe liver and kidney dysfunction, elderly people over 75 years old, life expectancy < 5 years (such as malignant tumors), mental or intellectual disabilities, before and after emergency large, small, and medium-sized surgeries, gastrointestinal or parenteral nutrition

Intervention implementation

Health knowledge learning and feedback:

□ Push disease related health knowledge in the form of official account

□ Ask the patient questions related to the health knowledge pushed on that day

□ Discuss key knowledge points in the group and invite patients to draw inferences from each other

Blood glucose monitoring, exercise, medication reminders: Reminder in the form of WeChat chat box text

Interactive consultation: Researchers establish a WeChat group where patients can discuss within the group. Participants can also send questions one-on-one to researchers for consultation

Intervention media

WeChat