A Telenursing Program to Support Diabetes Self-Management

May 8, 2026 updated by: Ramida Subpaiboonkit, Chiang Mai University

Development of Telenursing for Diabetes Self-Management Education and Support (DSMES) Among Patients With Type 2 Diabetes Mellitus in Thailand: A Randomized Controlled Trial

This randomized controlled trial aims to develop and evaluate a telenursing-based Diabetes Self-Management Education and Support (DSMES) program with uncontrolled type 2 diabetes mellitus in Thailand. The program is designed to improve diabetes self-management through nurse-led education, behavioral support, and regular follow-up delivered via telecommunication technologies.

Participants with type 2 diabetes and poor glycemic control will be randomly assigned to either an intervention group receiving a 12-week telenursing DSMES program or a control group receiving usual care. The intervention includes an initial in-person education session followed by structured video call follow-ups provided by nurse.

The primary outcome of this study is the feasibility of implementing telenursing for DSMES in Thailand. Secondary outcomes include changes in glycemic control (HbA1C , FBG), blood pressure, body mass index, diabetes knowledge, self-care behaviors, coping behaviors, quality of life, healthcare costs, and frequency of acute care use. The findings from this study are expected to provide evidence to support the use of telenursing as an accessible and sustainable approach for diabetes self-management in the Thai healthcare context.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

128

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Thailand
      • Chiang Mai, Thailand
        • Nong Pa Khrang Municipal Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • People with T2DM
  • Adults (age 20-64) and older adults (65 and above)
  • Uncontrolled diabetes, as determined by physician based on the diagnostic criteria of HbA1C > 7%
  • Can read and write
  • Own a smartphone
  • Having internet connectivity
  • Able to receive a video call or with assistance from a caregiver

Exclusion Criteria:

  • Insulin-dependent patients
  • Cognitive or mobility impairments , as assessed by the Thai Mental State Examination (TMSE). A TMSE score below 24 was considered indicative of cognitive impairment (The Nurse Association of Thailand, 2025).
  • Requiring special nursing care, such as patients with severe diabetic complications or those who are bedridden.
  • Previous extensive DSMES exposure

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Telenursing-Based DSMES Program
Behavioral: Telenursing-Based Diabetes Self-Management Education and Support
This intervention is a nurse-led, telenursing-based Diabetes Self-Management Education and Support (DSMES) program delivered over a 12-week period. It includes an initial face-to-face diabetes education session followed by scheduled follow-up sessions conducted via video calls. The program focuses on improving diabetes self-management through education, behavioral support, goal setting, problem-solving, and ongoing monitoring tailored to individual patient needs.
No Intervention: Usual care
control group : receive usual care

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Feasibility of telenursing for diabetes self-management education and support (DSMES)
Time Frame: at 12-week follow-up period after enrollment
Feasibility outcomes, including participation rate, completion rate, and adherence level, were analyzed using descriptive statistics under the per-protocol (PP) approach, which included only participants who completed all study assessments.
at 12-week follow-up period after enrollment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Healthcare costs
Time Frame: at 12-week follow-up period after enrollment
Healthcare costs will be assessed through review of medical and financial records, including outpatient visits, inpatient admissions, medications, laboratory tests, and other diabetes-related expenses. Total healthcare costs per participant will be summarized for the 12-week follow-up period.
at 12-week follow-up period after enrollment
Frequency of acute care use
Time Frame: at 12-week follow-up period after enrollment
Frequency of acute care use will be assessed using hospital records, including emergency department visits and hospital admissions. The total number of acute care events per participant will be recorded during the follow-up period.
at 12-week follow-up period after enrollment
All-cause mortality
Time Frame: at 12-week follow-up period after enrollment
All-cause mortality will be assessed using hospital follow-up records. Mortality status will be recorded for each participant during the follow-up period.
at 12-week follow-up period after enrollment
Glycated hemoglobin (HbA1c) level
Time Frame: From baseline to 12 weeks after enrollment
HbA1c (%) will be measured using standard laboratory methods obtained from medical records at baseline and 12 weeks after enrollment to assess changes over time.
From baseline to 12 weeks after enrollment
Fasting Blood Glucose (FBG)
Time Frame: From baseline to 12 weeks after enrollment
FBG (mg/dl) will be measured using standard laboratory methods obtained from medical records at baseline and 12 weeks after enrollment to assess changes over time.
From baseline to 12 weeks after enrollment
Blood pressure (BP)
Time Frame: From baseline to 12 weeks after enrollment
Blood pressure will be obtained from health assessment record at baseline and 12 weeks after enrollment to assess changes over time.
From baseline to 12 weeks after enrollment
Body Mass Index (BMI)
Time Frame: From baseline to 12 weeks after enrollment
Body mass index (kg/m²) will be calculated from measured weight and height obtained from health assessment record at baseline and 12 weeks after enrollment to assess changes over time.
From baseline to 12 weeks after enrollment
Diabetes knowledge
Time Frame: From baseline to 6 weeks and 12 weeks after enrollment
Diabetes knowledge will be assessed using the Thai version of the Diabetes Knowledge Scale (DIAKS), consisting of 21 items with true, false, or don't know response options. Total scores will be calculated based on the number of correct responses. Assessments will be conducted at baseline, 6 weeks, and 12 weeks after enrollment to assess changes over time.
From baseline to 6 weeks and 12 weeks after enrollment
Self-care behavior
Time Frame: From baseline to 6 weeks and 12 weeks after enrollment
Self-care behavior will be assessed using the Thai Diabetes Self-Management Questionnaire-Revised (T-DSMQ-R). Total scores will be calculated according to standard scoring procedures, with higher scores indicating better diabetes self-management. Assessments will be conducted at baseline, 6 weeks, and 12 weeks after enrollment to assess changes over time.
From baseline to 6 weeks and 12 weeks after enrollment
Positive coping behavior
Time Frame: From baseline to 6 weeks and 12 weeks after enrollment
Positive coping behavior will be assessed using the Short Thai Stress Test (ST-5), a five-item questionnaire rated on a 0-3 Likert scale. Total scores range from 0 to 15, with higher scores indicating greater stress severity. Assessments will be conducted at baseline, 6 weeks, and 12 weeks after enrollment to assess changes over time.
From baseline to 6 weeks and 12 weeks after enrollment
Quality of life (QoL)
Time Frame: From baseline to 6 weeks and 12 weeks after enrollment
Quality of life will be assessed using the Thai version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL19). The average weighted impact (AWI) score will be calculated, with scores ranging from -9 to +3. Assessments will be conducted at baseline, 6 weeks, and 12 weeks after enrollment to assess changes over time.
From baseline to 6 weeks and 12 weeks after enrollment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Chiang Mai University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 25, 2026

Primary Completion (Estimated)

May 27, 2026

Study Completion (Estimated)

May 27, 2026

Study Registration Dates

First Submitted

January 7, 2026

First Submitted That Met QC Criteria

January 16, 2026

First Posted (Actual)

January 26, 2026

Study Record Updates

Last Update Posted (Actual)

May 12, 2026

Last Update Submitted That Met QC Criteria

May 8, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2568-EXP092

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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