Evidence mapPaperPMID 42212245Full record

ArticleThe Lancet regional health. Southeast Asia2026

Self-management education and support for type 2 diabetes in Thailand: a cluster randomized trial (2019-2021).

Piyachon Aramrat, Iliatha Papachristou Nadal, Poppy Alice Carson Mallinson, Kanokporn Pinyopornpanish, Orawan Quansri, Kittipan Rerkasem, Supattra Srivanichakorn, Win Techakehakij, Nuthchanath Wichit, Kamlesh Khunti and 2 more

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Article in The Lancet regional health. Southeast Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Piyachon AramratDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Iliatha Papachristou NadalDepartment of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Poppy Alice Carson MallinsonDepartment of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Kanokporn PinyopornpanishDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Orawan QuansriASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.
Kittipan RerkasemDepartment of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Supattra SrivanichakornRoyal Thai Government Ministry of Public Health, Bangkok, Thailand.
Win TechakehakijLampang Hospital, Lampang, Thailand.
Nuthchanath WichitSurat Thani Rajabhat University, Surat Thani, Thailand.
Kamlesh KhuntiDiabetes Research Centre, Department of Health Sciences, University of Leicester, Leicester, UK.
Chaisiri AngkurawaranonDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Sanjay KinraDepartment of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Diabetes self-management education and support (DSMES) improves glycemia via improved care coordination and self-management behaviors driven by educational programs tailored to individual needs, but scalable models for its delivery in low- and middle-income countries are lacking. We evaluated the effectiveness of two scalable models of DSMES delivery: two sessions with a nurse (nurse-led) or one each with a nurse and a lay volunteer (peer-assisted). Methods: A three-arm cluster randomized trial was conducted comparing two DSMES interventions (nurse-led or peer-assisted) to routine care. The interventions consist of two DSMES sessions (once at baseline and a refresher at 6 months). The nurse-led group was delivered only by nurses, while the peer-assisted group was delivered by nurses with peer assistance. Seven primary care units were allocated to each arm. Newly diagnosed (at enrollment) or high risk glycemia (baseline HbA1c >10%) people with type 2 diabetes were eligible. Primary outcomes were differences in HbA1c and Thai-CV risk score (estimates ten-year risk of cardiovascular events in Thai population based on various clinical parameters) at 12 months relative to routine care. Secondary outcomes were individual cardiovascular risk factors. Findings: 693 individuals were enrolled (mean age 59 years, 269 (39%) male, and 424 (61%) female) and 664 completed the study (4% total drop-outs). For the control, nurse-led, and peer-assisted arms respectively, the means (SD) for primary outcomes are as follows. For HbA1c: at baseline; 8.5% (1.4), 8.5% (1.9), and 8.8% (2.0), at 12-month; 7.8% (1.6), 7.7% (1.3), and 8.1% (1.6). For Thai-CV risk scores: at baseline; 22 (15), 23 (15), and 23 (14) at 12-month; 21 (14), 23 (15), and 22 (13). Mean differences at 12-month from control (95% confidence intervals) for nurse-led and peer-assisted arms respectively were: HbA1c; -0.1% (-0.4 to 0.1) and 0.1% (-0.2 to 0.5), Thai-CV risk scores; 0% (-2 to 2) and -0% (-2 to 2). Interpretation: While there were no improvements in HbA1c or CV risk scores, low drop-out rates observed demonstrate the feasibility of the models. Future explorations of the appropriate balance between the intensity and feasibility of program delivery are needed. Funding: UK Medical Research Council (MR/R020876/1). Thailand Research Fund (DBG6180007).

Indexed as

Diabetes mellitusDiabetes self-management education and supportDSMESManagement educationPrimary careSelf-care

Identifiers

PMID42212245
PMCPMC13213673

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.