Self-Management Interventions for Adults with Type 2 Diabetes Mellitus in Thai Primary Care and Community Settings: A Scoping Review

Abstract

Diabetes mellitus is a leading cause of mortality and economic burden, with significant impacts on health outcomes and quality of life. Effective self-management is crucial for controlling Type 2 Diabetes Mellitus (T2DM). Thailand has implemented diverse self-management interventions for adults with T2DM in primary care and community settings, but the components, delivery, duration, and outcomes of these interventions have not been synthesized. Following the Arksey and O’Malley framework, Joanna Briggs Institute guidance, and PRISMA-ScR, five databases were searched from inception to June 2025. Eligible English-language intervention studies involved Thai adults with T2DM in primary care or community settings. Study characteristics and outcomes were summarized descriptively and narratively. Twenty-one studies involving 2,162 participants were included; 11 were randomized controlled trials. Interventions lasted approximately 4 weeks to 9 months, most commonly 12 weeks. Activities formed a three-phase pattern: preparation through education and skills training; action through self-management practice, monitoring, and follow-up support; and evaluation of clinical, behavioral, and psychosocial outcomes. Most studies reported improvements in at least one outcome, but no clear pattern by intervention duration was evident. Evidence was concentrated in Bangkok and Central Thailand, and few studies reported systematic needs assessment, stakeholder involvement, long-term follow-up, or digital delivery.

References

1. International Diabetes Federation (IDF). About Diabetes: Facts & Figures. Brussels: International Diabetes Federation; 2023.

2. Magliano DJ, Boyko EJ. IDF diabetes atlas, 10th edition. Brussels: International Diabetes Federation; 2021.

3. International Diabetes Federation. South-east Asia: Diabetes regional report 2000 - 2050. Brussels; International Diabetes Federation; 2026.

4. Department of Disease Control. The situation of non-communicable diseases (NCDs). Bangkok: Ministry of Public Health, Thailand; 2025.

5. Phrommintikul A, Dilokthornsakul P, Permsuwan U. Economic Burdens for Treatment of Patients With Type 2 Diabetes in North Thailand: A Hospital-Based Observational Study. Front Endocrinol. 2022; 13: 824545. DOI: 10.3389/fendo.2022.824545

6. International Diabetes Federation. Thailand: Diabetes country report 2000 - 2050. Brussels: International Diabetes Federation; 2025.

7. Khunkaew S, Fernandez R, Sim J. Demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus living in northern Thailand: A cross-sectional study. Health Qual Life Outcomes. 2019; 17: 177. DOI: 10.1186/s12955-019-1246-2.

8. Bodenheimer T, Lorig K, Holman H, et al. Patient self-management of chronic disease in primary care. JAMA. 2002; 288 (19): 2469-2475. DOI: 10.1001/jama.288.19.2469.

9. Corbin J, Strauss A. Managing chronic illness at home: Three lines of work. Qual Sociol. 1985; 8 (3): 224-247. DOI: 10.1007/BF00989485.

10. Lorig KR, Holman H. Self-management education: History, definition, outcomes, and mechanisms. Ann Behav Med. 2003; 26 (1): 1-7. DOI: 10.1207/s15324796abm2601_01.

11. Lorig K, Ritter PL, Villa FJ, et al. Community-based peer-led diabetes self-management: A randomized trial. Diabetes Educ. 2009; 35 (4): 641-651. DOI: 10.1177/0145721709335006.

12. Piyawadee T, Porntip M, Renu P, et al. Effectiveness of a self- and family management support program among older people with diabetic retinopathy and visual impairment: A randomized controlled trial. Pacific Rim Int J Nursing Res. 2023; 27 (1): 105-120. DOI: 10.60099/prijnr.2023.260336.

13. Kurtanty D, Bachtiar A, Candi C, et al. Information-Motivation-Behavioral Skill in Diabetes Self-management Using Structural Equation Modeling Analysis. Kesmas. 2023; 18 (1): 16-23. DOI: 10.21109/kesmas.v18i1.6255.

14. Areevut C, Sakmanarit J, Tachanivate P, et al. Noninferiority of Telemedicine Delivered Compared with in-person Diabetes Self-Management Education and Support (DSMES) During Covid-19 Pandemic in Thailand. Asia Pac J Public Health. 2022; 34 (8): 799-803. DOI: 10.1177/10105395221126010.

15. Jaipakdee J, Jiamjarasrangsi W, Lohsoonthorn V, et al. Effectiveness of a self-management support program for Thais with type 2 diabetes: Evaluation according to the RE-AIM framework. Nursing Health Sci. 2015; 17 (3): 362-369. DOI: 10.1111/nhs.12198.

16. Nooseisai M, Viwattanakulvanid P, Kumar R, et al. Effects of diabetes self-management education program on lowering blood glucose level, stress, and quality of life among females with type 2 diabetes mellitus in Thailand. Prim Health Care Res Dev. 2021; 22: e46. DOI:10.1017/S1463423621000505.

17. Sattayasomboon Y, Jiamjarasrungsi W, Lohsoonthorn V, et al. Effectiveness of self-management support program for type 2 diabetes mellitus in public health centers in Bangkok, Thailand: Randomised controlled trial. J Health Res. 2014; 28 (4): 269-276.

18. Arksey H, O'Malley L. Scoping studies: Towards a methodological framework. Int J Soc Res Method. 2005; 8 (1): 19-32. DOI: 10.1080/1364557032000119616.

19. Levac D, Colquhoun H, O'Brien KK. Scoping studies: Advancing the methodology. Implement Sci. 2010; 5 (1): 69. DOI: 10.1186/1748-5908-5-69.

20. Peters M, Godfrey C, McInerney P, et al. Chapter 11: Scoping reviews (2020 version). JBI Manual for Evidence Synthesis. Joanna Briggs Institute; 2020.

21. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMAScR): Checklist and explanation. Ann Intern Med. 2018; 169: 467–473. DOI: 10.7326/M18-0850.

22. Peters MDJ, Godfrey C, McInerney P, et al. Best practice guidance and reporting items for the development of scoping review protocols. JBI Evid Synth. 2022; 20 (4): 953-968. DOI: 10.11124/jbies-21-00242.

23. Kuper H, Nicholson A, Hemingway H. Searching for observational studies: What does citation tracking add to PubMed? A case study in depression and coronary heart disease. BMC Med Res Method. 2006; 6: 4. DOI: 10.1186/1471-2288-6-4.

24. Wright K, Golder S, López RR. Citation Searching: A systematic review case study of multiple risk behaviour interventions. BMC Med Res Method. 2014; 14: 73. DOI: 10.1186/1471-2288-14-73.

25. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021; 372: n71. DOI: 10.1136/bmj.n71.

26. Popay J, Roberts HM, Sowden AJ, et al. Guidance on the conduct of narrative synthesis in systematic reviews. A product from the ESRC Methods Programme (Version 1). 2006.

27. Snilstveit B, Oliver S, Vojtkova M. Narrative approaches to systematic review and synthesis of evidence for international development policy and practice. J Dev Effective. 2012; 4 (3): 409-429. DOI: 10.1080/19439342.2012.710641.

28. Ounprasertsuk J, Suksatan W, Saengphuean N, et al. Effectiveness of behavior modification program for diabetic patients in Suan Kluai health promoting hospital, ban pong district in Ratchaburi province, Thailand. Indian J Forensic Med Toxicol. 2021; 15 (2): 3747‐3754. DOI: 10.37506/ijfmt.v15i2.14957.

29. Sukchaisong N, Pichayapinyo P, Lagampan S, et al. Effectiveness of the Mindfulness-Based Diabetes Self- and Family Management Support Program among Adults with Uncontrolled Diabetes: A Randomized Controlled Trial. Pacific Rim Int J Nursing Res. 2022; 26 (3): 517-532.

30. Abdulsalam FI, Srichaijaroonpong S, Phoosuwan N, et al. Effectiveness of a health literacy and diabetes self-management education (DSME) improvement program for people with type 2 diabetes mellitus: A community-based quasiexperimental study in Thailand. J Diabet Res. 2025; 2025: 2640702. DOI: 10.1155/jdr/2640702.

31. Changsieng P, Pichayapinyo P, Lagampan S, et al. Implementation of Self-Care Deficits Assessment and a Nurse-Led Supportive Education Program in Community Hospitals for Behavior Change and HbA1c Reduction: A Cluster Randomized Controlled Trial. J Prim Care Comm Health. 2023; 14. DOI: 10.1177/21501319231181106.

32. Pitchalard K, Wimolphan P, Singkhorn O, et al. Feasibility and Acceptability of the HOME Model to Promote Self-Management Among Ethnic Minority Elderly with Type 2 Diabetes Mellitus in Rural Thailand: A Pilot Study. Health Equity. 2022; 6 (1): 629-637. DOI: 10.1089/heq.2021.0161.

33. Sawaengsri N, Maneesriwongul W, Schorr EN, et al. Effects of telephone-based brief motivational interviewing on self-management, medication adherence, and glycemic control in patients with uncontrolled Type 2 diabetes mellitus in a rural community in Thailand. Patient Pref Adher. 2023; 17: 2085-2096. DOI: 10.2147/PPA.S418514.

34. Kakahthum P, Lagampan S, Amnartsatsue K. Effects of health literacy improvement program on self-care behaviors and health outcomes in older adults with type 2 diabetes and hypertension comorbidities. J Public Hlth Dev. 2022; 20 (2): 32-34. DOI: 10.55131/jphd/2022/200203

35. Poonprapai P, Lerkiatbundit S, Saengcharoen W. Family support-based intervention using a mobile application provided by pharmacists for older adults with diabetes to improve glycaemic control: A randomised controlled trial. Int J Clin Pharm. 2022; 44 (3): 680-688. DOI: 10.1007/s11096-022-01389-5.

36. Wungrath J, Autorn N. Effectiveness of line application and telephone-based counseling to improve medication adherence: A randomized control trial study among uncontrolled type 2 diabetes patients. Health Promot Perspect. 2021; 11 (4): 438-443. DOI: 10.34172/hpp.2021.55.

37. Susilparat P, Pattaraarchachai J, Songchitsomboon S, et al. Effectiveness of contextual education for self-management in Thai Muslims with type 2 diabetes mellitus during Ramadan. J Med Assoc Thai. 2014; 97 (Suppl 8): S41-S49.

38. Wongrochananan S, Tuicomepee A, Buranarach M, et al. The effectiveness of interactive multi-modality intervention on self-management support of type 2 diabetic patients in Thailand: A cluster-randomized controlled trial. Int J Diabet Dev Countries. 2015; 35 (Suppl 2): S230-S236. DOI: 10.1007/s13410-015-0354-8.

39. Wichit N, Mnatzaganian G, Courtney M, et al. Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with Type 2 diabetes. Diabet Res Clin Pract. 2017; 123: 37‐48. DOI: 10.1016/j.diabres.2016.11.013.

40. Ounnapiruk L, Wirojratana V, Meehatchai N, et al. Effectiveness of a behavior modification program for older people with uncontrolled Type 2 Diabetes. Nursing Health Sci. 2014; 16 (2): 216-223. DOI: 10.1111/nhs.12089.

41. Prabsangob K, Somrongthong R, Kumar R, et al. Effectiveness of self-help group program for the management of type-2 diabetes patients in rural Thailand. Pakistan J Nutr. 2019; 18 (2): 141-145. DOI: 10.3923/pjn.2019.141.145.

42. Sukwatjanee A, Pongthavornkamol K, Suwaonnaroop N, et al. Enhancing self-care ability and quality of life among rural-dwelling Thai elders with type 2 diabetes through a self-help group: A participatory action research approach. Int J Behav Sci. 2009; 4 (1): 70-76.

43. Saengtipbovorn S, Taneepanichskul S. Effectiveness of lifestyle change plus dental care program in improving glycemic and periodontal status in aging patients with diabetes: a cluster, randomized, controlled trial. J Periodontol. 2015; 86 (4): 507-515. DOI: 10.1902/jop.2015.140563.

44. Thojampa S, Gunda K. Effect of self-management support and family participation enhancing program for delayed progression of diabetic nephropathy in Thai adults with type 2 diabetes. Int J Africa Nurs Sci. 2017; 7: 50-54. DOI: 10.1016/j.ijans.2017.08.001.

45. Wattana C, Srisuphan W, Pothiban L, et al. Effects of a diabetes self-management program on glycemic control, coronary heart disease risk, and quality of life among Thai patients with type 2 diabetes. Nurs Health Sci. 2007; 9 (2): 135-141. DOI: 10.1111/j.1442-2018.2007.00315.x.

46. Pengpid S, Peltzer K, Anantanasuwong D. Incident multimorbidity and associated factors among middle-aged and older adults in Thailand. Psychol Health Med. 2026; 31 (1): 1-12. DOI: 10.1080/13548506.2025.2478658.

47. Division of Non-Communicable Disease. Number and mortality rates from five non-communicable diseases (2017–2021). Bangkok, Division of Non-Communicable Disease; 2023.

48. Bartholomew LK, Parcel GS, Kok G, et al. Planning Health Promotion Programs: An Intervention Mapping Approach. San Francisco: Jossey-Bass A Wiley Imprint; 2006.

49. Nadal IP, Aramrat C, Jiraporncharoen W, et al. Process evaluation protocol of a cluster randomised trial for a scalable solution for delivery of Diabetes Self-Management Education in Thailand (DSME-T). BMJ Open. 2021; 11 (12): e056141. DOI: 10.1136/bmjopen-2021-056141.

50. Zimmerman BJ. Attaining self-regulation: A social cognitive perspective. In: Boekaerts M, Pintrich PR, Zeidner M, editors. Handbook of self-regulation. San Diego: Academic Press; 2000. DOI: 10.1016/B978-012109890-2/50031-7.

51. Estuningsih Y, Rochmah TN, Andriani M, et al. Effect of self-regulated learning for improving dietary management and quality of life in patients with type-2 diabetes mellitus at Dr. Ramelan Naval Hospital, Surabaya, Indonesia. Kesmas. 2019; 14 (2): 51–57. DOI: 10.21109/kesmas.v14i2.2257.

52. Kamillah S, Panduragan S, Poddar S, et al. Patients' Experiences in Using Diabetes Self-Management Application: A Scoping Review. Kesmas. 2022; 17 (5): 67-73. DOI: 10.21109/kesmas.v17isp1.5936.

53. Hearn J, Ssinabulya I, Schwartz JI, et al. Self-management of non-communicable diseases in low- and middle-income countries: A scoping review. PLoS One. 2019; 14 (7): e0219141. DOI: 10.1371/journal.pone.0219141.

54. Muhammad M, Yasmin F, Al-abed A, et al. Medication Adherence and Self-Management Practices among Type 2 Diabetes Mellitus Patients in Jeli District, Kelantan, Malaysia. Kesmas. 2022; 17 (4): 287-291. DOI: 10.21109/kesmas.v17i4.6216.

Recommended Citation

Seetangkham S , Seetunya S , Yodprong S , et al. Self-Management Interventions for Adults with Type 2 Diabetes Mellitus in Thai Primary Care and Community Settings: A Scoping Review. Kesmas. 2026; 21(3): 215-223
DOI: 10.7454/kesmas.v21i3.2743
Available at: https://scholarhub.ui.ac.id/kesmas/vol21/iss3/8