Summary: In 60 adults with type 2 diabetes, a family-centered empowerment program raised Diabetes Acceptance Scale scores (47.1 vs 34.66; P<0.001) and Diabetes Self-Management Questionnaire scores (36.37 vs 23.26; P<0.001) versus usual care at six weeks. The trial was small, single-centre and single-blind, and measured only questionnaire scores rather than glycaemic or clinical outcomes.
PICO Summary
| Element | Detail |
|---|---|
| Population | 60 adults with type 2 diabetes; single-blind randomized controlled trial with block randomization (sealed opaque envelopes); single centre, Iran. |
| Intervention | Family-centered empowerment program (FCEP) delivered to patients and their families to build illness acceptance and self-management; intervention arm n=30. |
| Comparison | Usual care (routine diabetes education and follow-up); control arm n=30. |
| Outcome | Groups were comparable at baseline (acceptance p=0.396; self-management p=0.305). At six weeks, illness acceptance (DAS) was higher with FCEP than usual care (47.1 ± 5.72 vs 34.66 ± 10.54; P<0.001), as was self-management (DSMQ) (36.37 ± 2.39 vs 23.26 ± 3.11; P<0.001). The same direction was seen immediately post-intervention (acceptance P=0.008; self-management P<0.001). No confidence intervals, effect sizes, ARR or NNT were reported, and no glycaemic or clinical endpoints were measured. |
Family-centered empowerment in type 2 diabetes
RCT · type 2 diabetes · 6 weeks
A family-centered empowerment program produced large gains in self-reported diabetes acceptance and self-management versus usual care. The trial was small, single-centre and short, with no glycaemic or clinical endpoints.
Expert Commentary
This single-blind randomized controlled trial reports that a family-centered empowerment program improved illness acceptance and self-management scores in adults with type 2 diabetes, and the between-group differences at six weeks are large and statistically significant. The signal is internally consistent: arms were balanced at baseline, scores diverged immediately after the program, and the gap widened by six weeks. Even so, the result should be read as encouraging rather than definitive. Both outcomes are self-reported questionnaire scores (the Diabetes Acceptance Scale and the Diabetes Self-Management Questionnaire), so the trial demonstrates a change in patient-reported attitudes and reported behaviour, not improvement in glycaemic control or any hard clinical endpoint. The most important limitation is the combination of small size (n=60), a single centre, and very short follow-up; questionnaire gains at six weeks may not persist or translate into lower HbA1c. Outcome assessors were blinded, but participants and families inevitably knew their allocation, which can inflate self-reported measures. Can I use this with my patients? Not yet as a standalone intervention, though it supports involving willing family members in education for motivated patients while we await larger trials with glycaemic outcomes. Future studies should report confidence intervals and effect sizes, extend follow-up, and anchor results to HbA1c.
References
Amani N, Nazari AM, Sanaie N, Abbasi A, Borhani F. Effects of family-centered empowerment program on illness acceptance and self-management of patients with type 2 diabetes: a randomized controlled trial. Sci Rep. 2025;15(1):21615. doi:10.1038/s41598-025-05833-0