Effect of Structured Diabetes Self-Management Education on Glycaemic Control and Quality of Life Among Type 2 Diabetes Patients in a Private Primary Care Clinic
TL;DR
Structured DSME is effective in improving glycemic control among T2DM patients within a short intervention period and holds potential for integration into national chronic disease management programs such as Prolanis.
Abstract
Background: Type 2 Diabetes Mellitus (T2DM) remains a major global and national health challenge, particularly in low- and middle-income countries such as Indonesia. The Chronic Care Model (CCM) identifies Diabetes Self-Management Education (DSME) as a key strategy to empower patients in self-care and glyceamic control. However, implementation of DSME in private primary care facilities remains limited. Objective: This study aimed to evaluate the effect of a structured DSME program on HbA1c levels and quality of life among T2DM patients enrolled in the Chronic Disease Management Program (Prolanis) at Firdaus 24-Hour Primary Clinic, Yogyakarta. Methods:A quasi-experimental pretest–posttest with control group design was employed involving 80 T2DM patients randomly assigned to intervention (DSME) and control (standard Prolanis) groups. The DSME program was delivered through six weekly interactive sessions. Primary outcomes were HbA1c levels and quality of life assessed using the WHOQOL-BREF (Indonesian version). Data were analyzed using ANCOVA General Linear Model at a significance level of 0.05, adjusting for insulin use, combination therapy, and comorbidities. Results: A total of 53 participants completed the study (26 intervention; 27 control). The DSME program significantly reduced HbA1c by 1.04% compared with the control group (p=0.003), demonstrating a meaningful improvement in glycemic control. Quality of life scores increased in the intervention group, though not statistically significant (p=0.384). Multivariate analysis confirmed that the DSME effect on HbA1c was independent of insulin therapy and comorbidities. Conclusion: Structured DSME is effective in improving glycemic control among T2DM patients within a short intervention period and holds potential for integration into national chronic disease management programs such as Prolanis. Long-term implementation and follow-up are recommended to assess sustained impacts on quality of life and