Inpatient-tailored diabetes self-management education and short-term glycemic change in type 2 diabetes: A pilot case series from RSUD dr. Darsono Pacitan

Mail Kun Arifah(1*)
Mail Agung Widiastuti(2)
Mail Ucik Ernawati(3)
Mail Yanti Dwi Kurniawan(4)


(1) Program Studi Profesi Ners, Fakultas Ilmu Kesehatan, Universitas Duta Bangsa Surakarta, Indonesia
(2) Program Studi Profesi Ners, Fakultas Ilmu Kesehatan, Universitas Duta Bangsa Surakarta, Indonesia
(3) Program Studi Profesi Ners, Fakultas Ilmu Kesehatan, Universitas Duta Bangsa Surakarta, Indonesia
(4) RS Indriati Solo Baru, Indonesia
(*) Corresponding Author

Abstract


Background: Type 2 diabetes mellitus (T2DM) commonly presents with uncontrolled hyperglycemia among inpatients, where self-management gaps compound clinical instability. Diabetes Self-Management Education (DSME) is recommended, yet evidence for inpatient-tailored, short-horizon DSME remains limited. Objective: To evaluate the short-term effect of a ward-adapted DSME adjunct on capillary blood glucose and self-management behaviors in hospitalized adults with T2DM. Methods: purposive sampling (n=2) in the Wijaya Kusuma Inpatient Ward, RSUD dr. Darsono (July-August 2025). The intervention comprised individual bedside DSME (two sessions; 60-90 minutes total) plus discharge reinforcement, delivered by diabetes-trained nurses. Primary outcome: change in capillary glucose (mg/dL) from baseline to post-intervention over 4 days with consistent testing conditions. Secondary outcome: Diabetes Self-Management Questionnaire (DSMQ-16; 0-64). Analyses emphasized descriptive trajectories; exploratory paired t-test/Wilcoxon and bootstrap 95% CIs were reported with α=0.05 (hypothesis-generating). Results: Baseline glucose was 837 and 511 mg/dL; by day 4, values declined to 130 and 120 mg/dL, respectively (absolute change -707 [-84.5%] and -391 [-76.5%]); no hypoglycemia/adverse events occurred. DSMQ-16 improved from 15 to 50 and 17 to 60 (poor to good). Exploratory tests were underpowered (paired t=3.47, p=0.18; Wilcoxon p=0.25), but the effect size was very large (Cohen’s d=2.46), consistent with observed trajectories. Conclusion: A ward-tailored DSME delivered over four days was feasible and associated with rapid, clinically meaningful glycemic improvement and substantial gains in self-management among acutely uncontrolled inpatients with T2DM. Findings are hypothesis-generating and support larger, controlled studies to confirm efficacy, durability post-discharge, and scalability.

Keywords


type 2 diabetes mellitus; DSME; inpatient education; self-management; capillary glucose; pilot study; Indonesia.

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DOI: https://doi.org/10.36419/avicenna.v9i1.1741

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