Summary: In 72 adults with type 2 diabetes in northeastern Thailand (36 intervention, 36 control), a one-day health literacy and diabetes self-management education (HL-DSME) program significantly raised total and four-dimension health literacy scores and the total self-management score, driven by the exercise dimension, compared with standard community education. No effect sizes, confidence intervals, or glycaemic (HbA1c) outcomes were reported.
PICO Summary
| Element | Detail |
|---|---|
| Population | 72 adults with type 2 diabetes in Sakon Nakhon Province, northeastern Thailand; community-based controlled study (labelled quasi-experimental in the title and randomised controlled in the abstract; registered TCTR20241120002). |
| Intervention | Health literacy and diabetes self-management education (HL-DSME) program: one day of theory plus a four-week follow-up period for reinforcement (n=36). |
| Comparison | Standard diabetes education as routinely delivered in the community (n=36). |
| Outcome | Intervention group significantly increased total health literacy score and all four health literacy dimensions, and significantly increased the total self-management score and the exercise-behaviour dimension, versus control. The abstract reports no effect sizes, 95% confidence intervals, p-values, ARR, or NNT, and reports no HbA1c or other glycaemic outcome. Other self-management dimensions were not reported as significant. |
Expert Commentary
This small community study suggests that a brief, structured health literacy and self-management program can raise health literacy and encourage exercise behaviour in adults with type 2 diabetes, and the verdict is that it shows promising behavioural and educational signals rather than proven clinical benefit. The reported outcomes are intermediate process measures: health literacy scores improved across all four dimensions, and self-management improved mainly through the exercise component, while other self-management dimensions were not significant. The key limitation is that the abstract presents no effect sizes, confidence intervals, or p-values, and reports no glycaemic outcome such as HbA1c, so the magnitude and clinical relevance of these gains cannot be judged from the available data, and the published design label is inconsistent (quasi-experimental in the title, randomised in the abstract), which weakens confidence in allocation. The sample of 72 is small, follow-up was short at four weeks, and questionnaire-based outcomes are prone to reporting bias in an unblinded, open-label setting. Can I use this with my patients? Not yet as evidence of better glycaemic control, but the educational structure is reasonable to adapt for low-literacy community clinics while better-powered trials with hard endpoints are awaited. Future work should report effect sizes and track HbA1c over a longer horizon.
References
Abdulsalam FI, Srichaijaroonpong S, Phoosuwan N, Phoosuwan N. Effectiveness of a Health Literacy and Diabetes Self-Management Education (DSME) Improvement Program for People With Type 2 Diabetes Mellitus: A Community-Based Quasiexperimental Study in Thailand. Journal of Diabetes Research. 2025;2025:2640702. doi:10.1155/jdr/2640702