{
  "abstract": "BackgroundType 2 diabetes (T2D) disproportionately affects socioeconomically disadvantaged communities. Evidence on the feasibility and effectiveness of prevention and self-management strategies in complex contexts remains limited.\n\nObjectiveTo report effectiveness outcomes from a feasibility trial comparing the SMART2D intervention with routine primary care for T2D prevention and control in two neighbourhoods in Stockholm.\n\nMethodsA cluster-randomized feasibility trial with hybrid type 1 design was conducted in two neighbourhoods among individuals at high risk of T2D (n=84) or with diagnosed T2D (n=58), allocated to an integrated care arm (n=70; personal coaching and community outreach) or facility-only arm (n=72; routine care). Primary outcomes were glycaemic control (participants with T2D) and HbA1c reduction (participants at high risk of T2D); secondary outcomes were retention to care and diabetes incidence (participants at high risk of T2D). Analysis used intention-to-treat principles: difference-in-differences with mixed-effects models for HbA1c reduction, and modified Poisson regression (IRR, 95% CI) for other outcomes.\n\nResultsAmong participants with T2D, glycaemic control (adjusted IRR=0.92, 95% CI=0.89-0.95) and retention to care (adjusted IRR=0.91, 95% CI=0.91-0.92) were significantly lower in the integrated care arm. Among participants at high risk of T2D, integrated care showed a marginally significant, greater HbA1c reduction (adjusted 2.02, 0.20-3.84) and significantly higher retention to care (adjusted IRR=1.22, 1.15-1.29), plus fewer incident diabetes cases (0 vs. 2 in facility-only).\n\nConclusionsIntegrated care (personal coaching, community outreach) benefited HbA1c reduction and retention among participants at high risk of T2D, whereas facility-only care improved glycaemic control and retention among participants with T2D.",
  "abstract_shown": true,
  "affiliations": [
    "Uppsala University"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "M. Daivadanam"
    },
    {
      "name": "K. Sidney Annerstedt"
    },
    {
      "name": "H. Alveson"
    },
    {
      "name": "L. Timm"
    },
    {
      "name": "C. Johan Sundberg"
    },
    {
      "name": "P. Delobelle"
    },
    {
      "name": "J. V. Olmen"
    },
    {
      "name": "P. Absetz"
    },
    {
      "name": "D. Guwatudde"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/608wvrjykecrv.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.30.26364359",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.30.26364359v1.full",
  "id": "608wvrjykecrv",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.30.26364359v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "public and global health"
    ],
    [
      "openalex",
      "2712|Diabetes Management and Education"
    ]
  ],
  "openalex": "W7216140888",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.30.26364359v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/608wvrjykecrv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:59Z",
      "native_id": "10.64898/2026.09.30.26364359",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.30.26364359v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:public and global health",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Proof-of-implementation of the SMART2D intervention: findings from a cluster randomised feasibility trial for prevention and control of type 2 diabetes in socio-economically disadvantaged neighbourhoods in Stockholm, Sweden",
  "title_text": "Proof-of-implementation of the SMART2D intervention: findings from a cluster randomised feasibility trial for prevention and control of type 2 diabetes in socio-economically disadvantaged neighbourhoods in Stockholm, Sweden",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:59Z",
  "url": "https://research.draconitic.com/paper/608wvrjykecrv",
  "venue": "medRxiv",
  "versions": []
}