Effect of patient-centered self-management intervention on glycemic control, self-efficacy, and self-care behaviors in South Asian adults with type 2 diabetes mellitus: a multicenter randomized controlled trial
Open accessAbstract
Abstract Background This study aimed to test the efficacy of patient‐centered self‐management intervention (PACE‐SMI) to improve HbA1c, self‐efficacy, and self‐care behaviors in adults with type 2 diabetes mellitus (T2DM). Methods In this multicenter, parallel two‐arm randomized controlled trial, 612 adults with T2DM and HbA1c ≥ 7% were enrolled and assigned to the control group ( n = 310) and the intervention group ( n = 302) using stratified permuted block randomization. The control group received usual care, whereas the intervention group received usual care plus nurse‐led, theory‐driven, culturally tailored PACE‐SMI, comprising eight weekly sessions of individualized education, counseling, behavioral training, and home visit. Outcomes were assessed at baseline, postintervention, and 3 months follow‐up. Results Data at 3 months were provided by 583 participants (control: n = 295, intervention: n = 288). Per‐protocol analysis showed that the intervention group had a lower mean HbA1c (8.49% [standard deviation (SD), 1.58]) than the control group (8.74% [SD, 1.62]), with small yet statistically significant mean difference of 0.25% (95% confidence interval [CI], −0.01 to 0.51; Cohen's d = 0.16; p = 0.03). Self‐efficacy and self‐care behaviors significantly improved in the intervention group (116.89 [SD, 25.50] and 70.01 [SD, 17.97]) compared to the control group (75.43 [SD, 18.99] and 51.54 [SD, 12.04]), with mean differences of 41.48 (95% CI, 37.83–45.13; Cohen's d = 1.84; p < 0.0001) and 18.56 (95% CI, 16.08–21.04; Cohen's d = 1.22; p < 0.0001), respectively. Linear regression analysis indicated the effect of PACE‐SMI on HbA1c was significantly mediated by improvements in self‐efficacy and self‐care behaviors ( R 2 = 0.232, p < 0.001). Conclusion PACE‐SMI led to modest but significant improvement in HbA1c and substantial enhancements in self‐efficacy and self‐care behaviors in adults with T2DM. image
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
By enabling repeated goal attainment and visible progress, digital wearable devices may help patients build confidence in their ability to manage exercise, which may in turn support the long-term maintenance of exercise behavior.
“By enabling repeated goal attainment and visible progress, digital wearable devices may help patients build confidence in their ability to manage exercise, which may in turn support the long-term maintenance of exercise behavior (30).”
From Behavior change pathways by which digital wearable devices support exercise self-management in type 2 diabetes: a scoping review with machine learning–assisted text mining (2026) · cites this paper as [30]
The Methods (Procedures; page unavailable) describe behavioral goals, feedback and reinforcement intended to build self-efficacy in self-care behaviors including physical activity. The Discussion (page unavailable) links improved self-efficacy to sustained lifestyle changes, but the intervention used sessions, visits, calls and SMS—not digital wearable devices—and the paper says its three-month follow-up cannot establish long-term maintenance. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B. B., Stein, C., Basit, A., Chan, J. C. N., Mbanya, J. C., et al. (2022) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.109119 · Cited by 10,123 · see citing works
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059 · see citing works
Human agency in social cognitive theory.
Bandura, A. (1989) · American Psychologist · doi:10.1037/0003-066x.44.9.1175 · Cited by 8,263 · see citing works
The summary of diabetes self-care activities measure: results from 7 studies and a revised scale.
Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000) · Diabetes Care · doi:10.2337/diacare.23.7.943 · Cited by 2,561 · see citing works
Effectiveness of Self-Management Training in Type 2 Diabetes
Norris, S. L., Engelgau, M. M., & Venkat Narayan, K. M. (2001) · Diabetes Care · doi:10.2337/diacare.24.3.561 · Cited by 1,846 · see citing works
IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021
Ogurtsova, K., Guariguata, L., Barengo, N. C., Ruiz, P. L., Sacre, J. W., Karuranga, S., Sun, H., Boyko, E. J., & Magliano, D. J. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.109118 · Cited by 996 · see citing works
Williams, R., Karuranga, S., Malanda, B., Saeedi, P., Basit, A., Besançon, S., Bommer, C., Esteghamati, A., Ogurtsova, K., Zhang, P., et al. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108072 · Cited by 865 · see citing works
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., et al. (2020) · Diabetes Care · doi:10.2337/dci20-0023 · Cited by 500 · see citing works
Taheri, S., Zaghloul, H., Chagoury, O., Elhadad, S., Ahmed, S. H., El Khatib, N., Amona, R. A., El Nahas, K., Suleiman, N., Alnaama, A., et al. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30117-0 · Cited by 393 · see citing works
van der Bijl, J., van Poelgeest‐Eeltink, A., & Shortridge‐Baggett, L. M. (1999) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.1999.01077.x · Cited by 386 · see citing works
Zhang, Y., Pan, X., Chen, J., Xia, L., Cao, A., Zhang, Y., Wang, J., Li, H., YANG, K. Y., Guo, K., et al. (2019) · Diabetologia · doi:10.1007/s00125-019-04985-9 · Cited by 360 · see citing works
O. B. O. T. C.-S. G., Grant, S., Mayo-Wilson, E., Montgomery, P., Macdonald, G., Michie, S., Hopewell, S., & Moher, D. (2018) · Trials · doi:10.1186/s13063-018-2735-z · Cited by 348 · see citing works
Luszczynska, A., & Schwarzer, R. K. (2015) · Research Bank (Australian Catholic University) · Cited by 198 · see citing works
American Association of Diabetes Educators (2020) · The Diabetes Educator · doi:10.1177/0145721719894903 · Cited by 184 · see citing works
Wichit, N., Mnatzaganian, G., Courtney, M. D., Schulz, P., & Johnson, M. (2016) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2016.11.013 · Cited by 175 · see citing works
García-Molina, L., Lewis-Mikhael, A.-M., Gallego, B. R., Ibáñez, N. C., Oliveras‐López, M., & Bueno‐Cavanillas, A. (2019) · European Journal of Nutrition · doi:10.1007/s00394-019-02147-6 · Cited by 163 · see citing works
The increasing rate of diabetes in Pakistan: A silent killer
Azeem, S., Khan, U., & Liaquat, A. (2022) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2022.103901 · Cited by 118 · see citing works
(2014) · Encyclopedia of Health Communication · doi:10.4135/9781483346427.n502 · Cited by 89 · see citing works
Asmat, K., Dhamani, K. A., Gul, R. B., & Froelicher, E. S. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.994766 · Cited by 89 · see citing works
Self-citationReducing the Risks of Diabetes Complications Through Diabetes Self-Management Education and Support
Kent, D., Melkus, G. D., Stuart, P., McKoy, J. M., Urbanski, P., Boren, S. A., Coke, L. A., Winters, J. E., Horsley, N. L., Sherr, D., et al. (2013) · Population Health Management · doi:10.1089/pop.2012.0020 · Cited by 80 · see citing works
Diabetes in Pakistan: addressing the crisis
Bhutta, Z. A., Haq, Z. U., & Basit, A. (2022) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00102-4 · Cited by 31 · see citing works
Predictors of self-care behaviors and glycemic control among patients with type 2 diabetes mellitus
Babazadeh, T., Lotfi, Y., & Ranjbaran, S. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1031655 · Cited by 27 · see citing works
Pakistan and diabetes—A country on the edge
Basit, A., Fawwad, A., & Baqa, K. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.11.001 · Cited by 24 · see citing works
Uddin, F., Ali, B., & Junaid, N. (2018) · PubMed · Cited by 21 · see citing works
Bukhsh, A., Khan, T. M., Phisalprapa, P., Duangjai, A., Saokaew, S., Nawaz, M. S., Ahmed, H. S., & Goh, B. H. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.754999 · Cited by 20 · see citing works
Khan, M. A., Walley, J. D., Khan, N., Hicks, J. P., Ahmed, M., Khan, S. E., Khan, M. A., Khan, H. J., & Harries, A. D. (2018) · BJGP Open · doi:10.3399/bjgpopen18x101618 · Cited by 16 · see citing works
Self-citationAzami, G., Soh, K. L., Sazlina, S.-G., Salmiah, M. S., & Aazami, S. (2018) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-018-0376-0 · Cited by 13 · see citing works
Qasim, R., Masih, S., Yousafzai, M. T., shah, H., Manan, A., Shah, Y., Yaqoob, M., Razzaq, A., Khan, A., & Rohilla, A. R. K. (2020) · BMC Endocrine Disorders · doi:10.1186/s12902-020-00572-x · Cited by 11 · see citing works
Asmat, K., Dhamani, K. A., Froelicher, E. S., & Gul, R. B. (2023) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s385715 · Cited by 11 · see citing works
Self-citationFritzen, K., Stautner, C., & Schnell, O. (2019) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2019.107897 · Cited by 10 · see citing works
Jiang, X., Jiang, H., Tao, L., & Li, M. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.767123 · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [25]Riaz S, Haq N, Nasim A, Sadiq Y, Tahir M. Translation and validation of diabetes management self‐efficacy questionnaire (DMSES) into Urdu language. Int J Biol Pharm Allied Sci. 2017; 6(6): 1244‐ 1254.
- [29]Manjula GB. Effects of Structured Educational Programme (SEP) on self efficacy self care behaviour and HbA1c values among patients with type 2 diabetes mellitus. Doctoral dissertation. Rajiv Gandhi University of Health Sciences India. 2016.
Cited by
Sorted by citations
Sun, W., Xie, D., Hou, W., Zhang, M., Wang, C., Wang, Z., Yang, H., Xu, G., & Dai, H. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1871682
- Authors
- Asmat, K., Sivarajan Froelicher, E., Dhamani, K. A., Gul, R., & Khan, N.
- Affiliations
- Shifa Tameer-e-Millat University (PK)
- Faculty of Nursing and Midwifery Shifa Tameer‐e‐Millat University Islamabad Pakistan
- Corresponding author
- Asmat, Kainat
- Venue
- Journal of Diabetes
- Publisher
- Wiley
- Published
- 2024-09
- Volume
- 16
- Issue
- 9
- Pages
- e13611-e13611
- ISSN
- 1753-0393 (ISSN-L)
- 1753-0407
- PMC
- PMC11391380
- OpenAlex
- W4402483587
- Cited by
- 38
- References
- 31
- Citations by year
- 2026: 28 · 2025: 9 · 2024: 1
- FWCI
- 11.17
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Diabetes (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, glycemic control, HbA1c, self-efficacy, self-care behavior, nurse-led intervention, culturally tailored interventions, South Asian adults, home visits, behavioral training, diabetes education, South Asian diaspora, diabetes self-management education
- MeSH terms
- Self-Management, Glycemic Control, South Asian People, Adult, Aged, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Patient Education as Topic, Self Care, Health Behavior, Patient-Centered Care, Self Efficacy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
