The Effects of Self-management Support Program on Knowledge, Exercise Behavior, Number of Steps, and Hemoglobin A1C among Type 2 Diabetes Patients

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Suchada Phuangchumpa
Kanchana Piboon
Wanlop Jaidee
Kasem Chaiklongkit


            This quasi-experimental research aimed to examine the effects of a self-management support program on knowledge, exercise behavior, number of steps and hemoglobin A1C blood sugar among type II diabetes mellitus patients. Seventy type II diabetes patients with 7 to 9 percent of hemoglobin A1C were equally randomized-divided into either the treatment or a control group. Thirty-five type II diabetes mellitus patients were in each group. The treatment group was intervened through self-management support program, while the control group received standard care. Research tools consist of four parts: self-management support program, questionnaires-consist of general characteristics, knowledge and exercise behavior questioners, pedometer and hemoglobin A1C examination. The data were analyzed using descriptive statistics, compare mean of knowledge, exercise behavior, number of step and hemoglobin A1C blood sugar between treatment and control group by using independent samples t-test, and repeated measure ANOVA. The results showed that post-intervention and follow up period after 28 weeks of self-management program, the average scores of knowledge, exercise behavior and number of steps were higher than the average scores of pre-intervention and control group (p < .05); and the average scores of hemoglobin A1C in follow up period after 28 weeks in the experimental group was lower than the pre-intervention and the control group (p < .05.). The finding of this study indicated that the self-management support program had outcomes which could help the type II diabetes patients to modify exercise behavior and a number of steps, could improve knowledge, and reduce hemoglobin A1C level. Therefore, health care providers can apply the self-management support program to promote knowledge, modifying behavior of type II diabetic patient group in other area.


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1. International Diabetes Federation. IDF Diabetes Atlas 8th Edition. [Internet]. [ cited 2019 March 15]. Available from:

2. Hfocus. Prevalence of diabetes mellitus in Thailand. [Internet]. [cited 15 March 2020]. Available from:

3. Chonburi Provincial Public Health Office. Health data center. [Internet]. [cited 15 March 2020]. Available from:

4. Center of Disease Control and Prevention. Type 2 diabetes. [Internet]. [cited 17 June 2019]. Available from:

5. Lorig K, Sobel D, Laurent D, González V, Marian M. Living a healthy life with chronic conditions. Colorado: Bull Publishing Company; 2006.

6. Institute of Medical Research and Technology Assessment. Exercise in patients with diabetes and hypertension. [Internet]. [cited 1 June 2019]. Available from:

7. Center of Disease Control and Prevention. Diabetes & mental health. [Internet]. [cited 15 June 2019]. Available from:

8. Chatterjee S, Riewpaiboon A, Piyauthakit P, Riewpaiboon W, Boupaijit K, Panpuwong N, et al. Cost of diabetes and its complications in Thailand: a complete picture of economic burden. Health Soc Care Community 2011;19(3):289-98.

9. American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017; 40:S1-S142.

10. Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care 2016;39:2065-79.
11. Pai LW, Li TC, Hwu YJ, Chang SC, Chen LL, Chang PY. The effectiveness of regular leisure-time physical activities on long-term glycemic control in people with type 2 diabetes: a systematic review and meta-analysis. Diabetes Research and Clinical Practice 2016;113:77-85.

12. Tachanivate P, Phraewphiphat R, Tanasanitkul H, Jinnawaso R, Areevut C, Rattanasila R, et al. Effectiveness of diabetes self-management education in Thais with type 2 diabetes. Pacific Rim Int J Nurs Res 2019;23(1):74-86

13. Piboon K, Jaidee W, Chaiklongkit, K. A systematic review of type 2 diabetic care intervention among elderly people. The Journal of Faculty of Nursing Burapha University 2015;23(2):1-9. (in Thai).

14. Panagioti M, Richardson G, Small N, Murray E, Rogers A, Kennedy A, et al. P. Self-management support interventions to reduce health care utilization without compromising outcomes: a systematic review and meta-analysis. BMC Health Serv Res 2014;14:1-14.

15. Chrvala CA, Sherr D, Lipman RD. Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient Educ Couns 2016;99(6):926–43.

16. Glasgow RE, Emont S, Miller DC. Assessing delivery of the five ‘As’ for patient-centered counseling. Health Promotion International 2006;25(3):413-33.

17. Glasgow RE, Davis CL, Funnell MM, Beck A. Implementing practical interventions to support chronic illness self-management in health care settings: lessons learned and recommendations. Jt Comm J Qual Saf 2003;29(11):563-74.

18. Peters-Klimm F, Campbell S, Hermann K, Kunz CU, Muller-Tasch T, Szecsenyi J, et al. Case management for patients with chronic systolic heart failure in primary care: the HICMan exploratory randomized controlled trial. Trials 2010;11:56.

19. Suwankruhasn N, Pothiban L, Panuthai S, Boonchuang P. Effects of a self-management support program for Thai people diagnosed with metabolic syndrome. Pacific Rim Int J Nurs Res 2013;17(4)371-83.
20. King DK, Glasgow RE, Toobert DJ, Strycker LA, Estabrooks PA, Osuna D, et al. Self-efficacy, problem solving, and social-environmental support are associated with diabetes self- management behaviors. Diabetes Care 2010;33(4):751-3.

21. Polit DF, Beck CT. Nursing research: principles and methods. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2004.

22. Tongvichean T, Aungsuroch Y, Preechawong S. Effect of self-management exercise program on physical fitness among people with prehypertension and obesity: a quasi experiment study. Pacific Rim Int J Nurs Res 2019;23(1):6-17.

23. Kaewsongk P, Masingboon K, Keeratiyutawong P, Melkus GD, Deoisres W. Effects of a self-management support program on foot care knowledge, foot care behaviors perceived social facilitation support and HbA1C among people with type 2 diabetes at low risk of diabetes foot complications. Journal of Police Nurse 2018;10(2):385-99. (in Thai).

24. van Olmen J, Ku GM, van Pelt M, Kalobu JC, Hen H, Darras C, et al. The effectiveness of text messages support for diabetes self-management: protocol of the TEXT4DSM study in the democratic Republic of Congo, Cambodia and the Philippines. BMC Public Health 2013;13(1):413.

25. Hoye KV, Boen F, Lefevre J. The effects of physical activity feedback on behavior and awareness in employees: study protocol for a randomized controlled trial. Int J Telemed Appl 2012; doi: 10.1155/2012/460712.

26. Angboonta P, Pothiban L, Kosachunhanun N. Effects of a self-management supporting program on self-management behaviors and hemoglobin A1C level among elders with diabetes type 2. Nursing Journal 2012;39(3):93-104. (in Thai).

27. Qiu S, Cai X, Chen X, Yang B, Sun Z. Step counter use in type 2 diabetes: a meta-analysis of randomized controlled trials. BMC Medicine 2014;12(1):36.

28. De Greef KP, Deforche BI, Ruige JB, Bouckaert JJ, Tudor-Lockee CE, Kaufmand J, et al. The effects of a pedometer-based behavioral modification program with telephone support on physical activity and sedentary behavior in type 2 diabetes patients. Patient Education and Counseling 2011;84(2):275-9.

29. Conroy MB, Yang K, Elci OU, Gabriel KP, Styn MA, Wang J, et al. Physical activity self-monitoring and weight loss: 6-month results of the SMART trial. Med Sci Sports Exerc 2011;43(8):1568-74.

30. De Greef K, Deforche B, Tudor-Locke C, De Bourdeaudhuij I. Increasing physical activity in Belgian type 2 diabetes patients: a three-arm randomized controlled trial. Int. J. Behav Med 2011;18:188-98.

31. American Diabetes Association. Blood sugar and exercise. [Internet] [cited 2019 December 28]. Available from:

32. Piboon K. Exercise for type 2 diabetes patients. Journal of Health Science 2018;27(1):169-77. (in Thai).

33. Yuenyongchaiwat K, Pipatsitipong D, Sangprasert P. Increasing walking steps daily can reduce blood pressure and diabetes in overweight participants. Diabetol Int 2018;9:75-9.

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