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 Nov;34(8):799-803. doi: 10.1177/10105395221126010. Epub 2022 Sep 19.


This study aimed to compare the clinical outcomes and program satisfaction of diabetes self-management education and support (DSMES) for type 2 diabetes patients delivered by telehealth during COVID-19 pandemic to in-person delivery during pre-COVID-19. A retrospective case-controlled study was conducted (95 telehealth and 95 on-site). Differences in hemoglobin A1c (HbA1c) reductions between groups were analyzed by linear mixed-effects models, and satisfaction was collected. Compared with baseline, at the three-month follow-up, the HbA1c reductions of the telehealth and on-site DSMES were 1.20 ± 0.15% and 1.21 ± 0.15%, respectively (P < .001), whereas these were 1.28 ± 0.16% and 1.18 ± 0.15% at six-month follow-up, respectively (P < .001). There were no significant differences in HbA1c reduction between the two groups (P = .967 and .674 at three- and six-month follow-up). Majority of participants in both groups had high program satisfaction (telehealth 98.7% vs on-site 95.1%, P = .269). In conclusion, DSMES delivered via telehealth is as effective in lowering HbA1c as that delivered in-person, with a high satisfaction rate.

Keywords: covid-19; diabetes self-management education and support; multidisciplinary team; patient-generated health data; telehealth.

MeSH terms

  • COVID-19*
  • Diabetes Mellitus, Type 2* / therapy
  • Glycated Hemoglobin / analysis
  • Humans
  • Pandemics
  • Retrospective Studies
  • Self-Management* / education
  • Telemedicine*
  • Thailand


  • Glycated Hemoglobin A