Effectiveness of intensive lifestyle modification program to diabetes remission in type 2 diabetic patients at Subdistrict Health Promoting Hospital, Suratthani province

Abstract

     This study employed a quasi-experimental research design with a two-group pretest–posttest design. The objective was to evaluate the effectiveness of an intensive lifestyle modification program for achieving type 2 diabetes remission. The outcomes included glycemic control, reduction in antidiabetic medication use, discontinuation of antidiabetic medications, and participants’ satisfaction with the intensive lifestyle modification program. The sample consisted of 256 patients with type 2 diabetes mellitus receiving treatment at four Subdistrict Health Promoting Hospitals. Participants were selected using purposive sampling according to the inclusion criteria and were assigned to either the experimental group (n = 128) or the comparison group (n = 128). The experimental group received the intensive lifestyle modification program, whereas the comparison group received usual care. The research instruments included: 1) the intensive lifestyle modification program, 2) a health status record form, and 3) a self-care behavior and satisfaction questionnaire. Data were collected between January and June 2026. Data were analyzed using descriptive statistics, the Chi-square test, the independent t-test, and the paired-samples t-test.

     The findings revealed that after 3 months of the intensive lifestyle modification program, patients with type 2 diabetes showed significant improvements in overall self-care behaviors and all domains, including healthy eating, physical activity, stress management, and risk reduction. In addition, body mass index (BMI), waist circumference, and glycated hemoglobin (HbA1c) levels were significantly reduced (p < 0.001). After 6 months of the intervention, compared with the 3 months assessment, BMI, waist circumference, and HbA1c levels further decreased significantly (p < 0.001). Furthermore, compared with the control group, the intervention group demonstrated significantly better overall and domain-specific self-care behaviors (healthy eating, physical activity, stress management, and risk reduction), together with greater reductions in BMI, waist circumference, and HbA1c levels at both 3 and 6 months (p < 0.05). Following the intensive lifestyle modification program, 24.2% and 43.0% of patients achieved glycemic control at 3 and 6 months, respectively. The proportions of patients who were able to reduce their diabetes medications were 14.1% and 21.1% at 3 and 6 months, respectively, while 7.8% of patients were able to discontinue diabetes medication after 6 months. Overall, 87.5% of participants reported a high level of satisfaction with the program.