Development of an Empowerment Program for Self-Management on Blood Glucose Control Ability to Achieve Diabetes Remission Among Patients with Diabetes Prepared for Hospital Discharge

Abstract

     This study aimed to (1) develop an empowerment program for self-management among patients with type 2 diabetes who were prepared for hospital discharge, (2) examine the effects of the program on patients’ ability to control blood glucose levels, and (3) investigate the program’s impact on achieving diabetes remission after hospital discharge. This research employed a Research and Development (R&D) approach combined with a quasi-experimental design using a one-group pretest–posttest design. The sample consisted of 34 patients with type 2 diabetes who were receiving treatment at Singhanakhon Hospital, Songkhla Province, and were selected through purposive sampling based on predetermined inclusion criteria. The research instruments included (1) the self-management empowerment program, consisting of four phases: admission, inpatient care, discharge preparation, and a three-month follow-up; (2) a personal information and clinical data record form; (3) a self-management behavior questionnaire; and (4) a diabetes remission assessment form. Data were analyzed using descriptive statistics and a dependent t-test to test hypotheses.

     The results revealed that after participating in the program, the overall self-management behavior score significantly increased (t = -17.43, p < .001) from a mean of 34.88 ± 9.85 to 62.24 ± 3.54, representing a 78.4% improvement. The most substantial improvement was observed in self-monitoring of blood glucose, which increased by 226.8%. Clinical indicators also improved significantly: fasting blood sugar (FBS) decreased from 222.79±67.35 mg/dL to 179.79±45.62 mg/dL (a 19.3% reduction, p < .001), and glycated hemoglobin (HbA1c) decreased from 10.72±2.18% to 10.24±1.89% (a 4.5% reduction, p = .039). Body mass index (BMI) and both systolic and diastolic blood pressure values also significantly decreased. However, no participants achieved diabetes remission within the three-month follow-up period, as all patients still required hypoglycemic medication and maintained HbA1c levels above the defined threshold.