Hedwig Acham, Kenyi John, Andrew Kiri
Abstract
Background: Type 2 diabetes (T2D) is a growing health challenge, affecting over 6% of the global population and contributing to rising mortality rates. In South Sudan, the burden is intensified by fragile health systems, limited resources, and poor access to education and care, making the effective management of chronic conditions difficult. Diabetes self-management education (DSME) is widely appreciated for its role in improving glycemic control. Although its efficacy has been demonstrated in various global contexts, it remains underutilized in South Sudan, and its impact has not been systematically evaluated.
Objective: This study evaluated the effectiveness of a culturally adapted DSME program in improving glycemic control among adults (45+ years) with T2D attending the Malakia Primary Health Care Centre in Juba County.
Methods: A randomized controlled trial (RCT) was conducted involving 132 participants. The intervention group received structured DSME sessions, while the control group received general health education (GHE). The outcomes included clinical and self-care behaviors, diabetes knowledge, and quality of life among adults. Data were analyzed using paired and independent t-tests, ANCOVA, logistic and linear multivariate regressions.
Results: The intervention group showed statistically significant improvements in fasting blood glucose levels (−16.6 mg/dL), body mass index (−2.18 kg/m²), and blood pressure (−4.51 mmHg systolic, −2.28 mmHg diastolic), all at p<0.001. Both Diabetes knowledge and quality of life improved (+1.75, p < 0.001; -1.82, p < 0.001; respectively). Results of ANCOVA demonstrated the effectiveness of the intervention, significantly improving glycaemic control, BMI, blood pressure, self-care behavior, dietary knowledge, and quality of life after adjusting for baseline differences (P<0.01); the largest intervention effects were observed for dietary knowledge and quality of life.
Conclusion: The findings demonstrate that DSME is a feasible, impactful, and scalable intervention for South Sudan.
Keywords: Diabetes Self-Management Education (DSME), Glycemic Control, Type 2 Diabetes, Randomized
Controlled Trial (RCT)
Download the PDF File Effectiveness of Diabetes Self-Management Education on Glycemic Control in Adults with Type 2 Diabetes: Evidence from Juba County, South Sudan.
