Effect of simulation education and case management on glycemic control in type 2 diabetes

Diabetes Metab Res Rev. 2019 Mar;35(3):e3112. doi: 10.1002/dmrr.3112. Epub 2018 Dec 21.


Background: The aim of the study was to investigate whether simulation education (SE) and case management had any effect on glycemic control in type 2 diabetes (T2DM) patients.

Methods: In this single center pilot trial, 100 T2DM patients who received medication and basic diabetes self-management education (DSME) were randomly divided into a control group (n = 50) and an experimental group (n = 50), who received SE and a case management program. Evaluation of biochemical indices was conducted at baseline and after 6 months. DSME consisted of 2-hour group trainings weekly for 2 consecutive weeks followed by 2 × 30 minute education sessions after 3 and 6 months. The SE program comprised additional 50-minute video sessions 3 times in the first week and twice in the second week. The experimental group was supervised by a nurse case manager, who followed up participants at least once a month, and who conducted group sessions once every 3 months, focusing on realistic aspects of physical activity and nutrition, with open discussions about setting goals and strategies to overcome barriers.

Results: After 6 months, HbA1c, fasting plasma glucose, and postprandial blood glucose level improvements were superior in the experimental group compared with the control group (P < 0.05). Self-care behavior adherence scores of healthy diet (P = 0.001), physical activity (P = 0.043), self-monitoring of blood glucose (P < 0.001), and reducing risks (P < 0.001) were significantly increased in the experimental group compared with the control group.

Conclusions: Simulation education and case management added to routine DSME effectively improved glycemic control in T2DM patients.

Keywords: HbA1c; T2DM; blood glucose control; case management; diabetes self-management education (DSME); self-care behaviours; simulation education (SE).

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / analysis
  • Case Management*
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / psychology
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Patient Education as Topic*
  • Pilot Projects
  • Prognosis
  • Quality of Life
  • Self Care / methods*
  • Self Care / psychology
  • Simulation Training / methods*


  • Biomarkers
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human