Quantifying and understanding the roles of diabetes educators in Malaysian primary health clinics: a mixed-methods study.

This article reports the results of the 2025 National Practice Survey (NPS), documenting professional engagement in the diabetes care and education specialist (DCES) specialty, conducted by the Association of Diabetes Care & Education Specialists (ADCES). The quantitative NPS survey was administered online using email addresses compiled from ADCES and Certification Board for Diabetes Care and Education. Data were collected over a 4-week period in 2025. Descriptive and correlative statistics were used to identify relationships between variables and are discussed in the context of existing literature and previous NPS surveys. The responses from the 2479 respondents to this NPS find those serving as DCESs to be a diverse group of professionals, working within the context of both an expanding diabetes care team and population with diabetes. While serving disparate populations, they appear, as a group, to actively seek out training opportunities to further their understanding of those they work with and professional credentialing and other educational advancement. DCESs appear to have an expanded role in patient care and increased responsibility in providing colleagues and people with diabetes with guidance on diabetes-related technology. Given the advances in the care and treatment of diabetes, DCESs are an important conduit for patient-centered care. Understanding the current practice of the DCES provides insights to address the evolving needs of diabetes prevention, diabetes and cardiometabolic syndrome care, treatment, and education with a workforce prepared to integrate technology and best practices for people living with diabetes.

The European Society for Paediatric Endocrinology (ESPE) e-Learning wesite is a free, globally accessible online resource to enhance learning in pediatric endocrinology and pediatric diabetes. The content is created by world-leading experts in pediatric endocrinology and pediatric diabetes and is closely aligned with published international consensus guidelines. In August 2022, 30 hours of e-learning courses received accreditation from the European Accreditation Council for Continuing Medical Education (CME). These CME courses cover three categories: (1) pediatric endocrinology, (2) pediatric diabetes, and (3) pediatric endocrinology in resource-limited settings. This study aimed to assess learners' demographics and feedback from mandatory surveys after completion of CME e-learning courses and to identify areas for improvement. The ESPE e-learning committee created a mandatory survey for each CME e-learning module. The survey includes baseline demographics and feedback on the quality of the learning content, assessed using a 5-point Likert scale. Data were extracted from the start of the CME modules in August 2022 until September 2025. A total of 567 surveys were completed: 286 (50.4%) in the category pediatric endocrinology, 225 (39.7%) in the category pediatric diabetes based on the International Society for Pediatric and Adolescent Diabetes guidelines, and 56 (9.9%) in the category pediatric endocrinology in resource-limited settings. There was global participation, with most learners practicing in Europe (n=333, 59%), followed by Asia (n=124, 22%), Africa (n=53, 9%), the Americas (North America, n=45, 8%; and South America, n=11, 2%), and Oceania (n=1, 0%). Most of the users indicated that they were medical experts (n=210, 37%), followed by fellows or residents (n=223, 39%), and medical students and nurses (n=29, 5% and n=32, 6%, respectively); overall, 10% (n=56) of learners practice in resource-limited countries. Overall, the learning content was well received for all modules regarding accessibility, organization, level of interest, improvement of learners' clinical practice, appropriateness of content, and provision of feedback (median Likert score 4, IQR 4-5). Learners' free-text feedback identified some areas for improvement, including reducing text-heavy content and providing more graphical content and more interactive case reports. Most learners' free-text feedback consisted of encouraging and thankful comments. The ESPE CME-accredited e-learning modules are well received, providing globally free CME education in pediatric endocrinology and pediatric diabetes. These findings support the continued development and promotion of open-access CME platforms, with the aim of improving global equity in specialist medical education and focusing on educational impact.

Nutrition education is important for managing type 2 diabetes (T2D), and how much knowledge is retained after nutrition education for new onset diabetes is challenging to assess. We hypothesize that deployment of a nutrition assessment will reinforce nutrition knowledge in newly diagnosed youth withT2D. An exploratory quality improvement project was conducted to evaluate nutrition knowledge retained following new diagnosis of T2D. We implemented an 18-item nutrition assessment (at the first or second outpatient visit) evaluating nutrition label reading, hypoglycemia/hyperglycemia management, insulin management, and physical activity. Data was collected from the medical record, and descriptive and summary statistics were performed. Quizzes were administered to 19 patients and their caregivers, mean patient age 14.9±2.1 years, 68 % female, 68 % NH Black, 79 % publicly insured, with mean HbA1c 11.3 % at diagnosis, and 8.2 % at time of assessment. Mean overall nutrition assessment score was 14/18 (76 %). Patients scored well on questions about insulin (87 % correct) and physical activity (90 % correct) but needed additional reinforcement on questions about general nutrition (61 % correct) and acute and chronic complications of diabetes (64 % correct). Patients who had a lower HbA1c at follow-up scored higher on the quiz (p=0.037). Dietitians commented that the assessments allowed them to gain "quick insight" into patients' baseline knowledge, which enabled more tailored nutrition education with each patient. Implementation of nutrition assessments during comprehensive diabetes visits is feasible and facilitates nutrition education with the patient and/or caregiver in an engaging manner. Reinforcement of nutrition education is critical for type 2 diabetes management and outcomes.

Developing user-centered digital health hardware requires systematic design methods applicable across clinical contexts. As diabetes mellitus continues to rise globally and contributes to morbidity, mortality, and costs, effective nutritional management remains essential-yet adherence is often poor. Digital health interventions grounded in human-centered design may enhance adherence by better aligning solutions with patients' real needs. This tutorial aims to provide replicable guidance on applying the design thinking approach to health care hardware development, illustrated through the design, development, and preliminary usability evaluation of SMARTCLOTH (GA-16: Lifestyles, Innovation, and Health), a smart tablecloth prototype intended to facilitate dietary management and support adherence to nutritional recommendations among individuals with diabetes. We demonstrate a systematic design thinking approach adaptable to other hardware contexts, using the Double Diamond model. In mapping, we performed a structured preassessment to define project scope and feasible functionalities. To characterize end user needs, we conducted 6 in-depth interviews with health care professionals and applied persona, empathy map, and customer journey map tools. In exploring, 5 focus groups (patients and diabetes educators) identified barriers, facilitators, and desired functionalities for dietary self-management. In building, we created low- and high-fidelity wireframes and interactive web prototypes using Phaser 3 (HTML5/JS) to simulate a kitchen workspace for meal assembly. In testing, 7 patients with different diabetes profiles participated in 3 iterative usability sessions. Using think-aloud, video analysis, and structured tasks, we documented completion times, errors, and the level of required assistance, enabling refinements. Development progressed through 15 internal versions and 3 user-tested prototypes with real-time adjustments when feasible. Interviews and focus groups yielded three user profiles guiding design: (1) adolescents with type 1 diabetes navigating social and dietary challenges, (2) working-age adults with type 2 diabetes who were motivated but inconsistent, and (3) older adults with type 2 diabetes showing low adherence due to entrenched habits. Iterative usability testing indicated that the system was intuitive, with improvements in layout, labeling, and navigation. Quantitative metrics showed refinement, with simple tasks being completed in under 1 minute in later iterations, while complex meal simulations took longer. Error rates and required guidance decreased as prototypes evolved. Qualitative feedback highlighted clarity, motivational value, and educational potential, while older participants requested larger text and simplified controls. Despite usability gains, motivational barriers persisted among low-adherence older adults. This tutorial demonstrates that systematic human-centered design can yield feasible and well-accepted digital health hardware. SMARTCLOTH emerged as a promising tool for dietary management in diabetes, though effectiveness and clinical outcomes were not evaluated. The methodology can be adapted by teams developing hardware for chronic disease management.

The Diabetes Care and Education Specialist Role in Insulin Pump Therapy

To comprehensively analyze the characteristics of type 1 diabetes and compare the differences between childhood-onset and adult-onset groups. Hospital records of patients with type 1 diabetes of all ages were collected from 18 hospitals across 14 prefectures in Northwest China between January 2016 and October 2023. Data included demographic characteristics, manifestation at onset, physical examination, laboratory tests, and management. Based on diagnosis status, participants were classified into newly diagnosed and previously diagnosed groups. Additionally, according to the age at onset, participants were further divided into childhood-onset and adult-onset groups. Among the 1,513 individuals with type 1 diabetes, the newly diagnosed group showed a younger median age of onset, lower mean body mass index, and better β-cell function compared with the previously diagnosed group. Diabetic ketoacidosis at diagnosis was common, and the prevalence of chronic complications increased with disease duration. Most patients in both groups used multiple daily injections. Additionally, patients with childhood-onset type 1 diabetes were more likely to have diabetic ketoacidosis at diagnosis and had higher HbA1c levels at disease onset, lower BMI levels, and lower prevalence of complications compared with those with adult-onset diabetes. This multicenter, hospital-based study provided an overview of the characteristics of patients with type 1 diabetes. These findings may contribute to a better understanding of type 1 diabetes and underscore the importance of long-term diabetic education and management.

Purpose: To report a rare case of cesarean scar ectopic pregnancy (CSEP) complicated by placenta accreta spectrum (PAS), managed expectantly, culminating in cesarean hysterectomy at 32 weeks of gestation. Methods: Case Report. Results: A 40-year-old G5P3013 with three prior cesarean deliveries presented with spotting and pelvic cramping. Transvaginal ultrasound suggested a 6-week CSEP. She was hemodynamically stable, with minimal vaginal bleeding and a closed cervix. Her body mass index (BMI) was 40 kg/m², and she had a 15-pack-year smoking history. Maternal-fetal medicine (MFM) confirmed the diagnosis and counseled her extensively on risks, benefits, and alternatives, recommending management via termination or hysterectomy. Risks of significant hemorrhage, cesarean hysterectomy, bladder injury, uterine rupture, miscarriage, and other serious maternal morbidities were discussed thoroughly. The patient chose expectant management and close MFM follow-up. At 15 weeks, her ultrasound raised concerns for placenta accreta spectrum (PAS). She also had several blood pressures around 140/90 mmHg and was started on 81 mg of daily aspirin for preeclampsia prevention in the setting of her chronic hypertension. She failed both the 1-hour and 3-hour glucose tolerance tests, despite an early first-trimester A1c of 4.9%. She met with a diabetes educator and began logging her blood sugar levels. At 24 weeks, ultrasound confirmed placenta increta. Risks of hemorrhage, invasion of surrounding structures, cesarean hysterectomy, blood transfusion, and maternal and fetal death were again extensively discussed. Gynecologic Oncology was consulted and noted definitive need for hysterectomy and the possibility of leaving the placenta in situ to avoid life-threatening hemorrhage. This would be a decision at time of cesarean delivery, regardless of imaging. Magnetic resonance imaging was negative for placenta percreta. At 32 weeks, she was admitted from high-risk clinic due to ultrasound findings of extreme thinning of the lower uterine segment, with much of the pregnancy either bulging or extrauterine. Betamethasone was administered for fetal lung maturation, which lead to hyperglycemia. The decision was made to deliver within the week. Four units of type and crossmatched packed red blood cells (pRBCs) were made available. The day prior to delivery, the patient became hypoxic, and a chest x-ray revealed pulmonary edema and/or atelectasis. She was placed on an IV insulin drip for 24 hours preoperatively, and tight glucose control was achieved. At 32 weeks and 4 days, she underwent cesarean delivery via vertical midline and vertical uterine incisions. The infant had APGARs of 8 and 9 and weighed 5 lbs 14 oz. Gynecology oncology then performed an exploratory laparotomy, cesarean hysterectomy, and lysis of adhesions. Estimated blood loss was 2,300 mL. She received 2 units of pRBCs, 1 unit of fresh frozen plasma, and 4.6 L of crystalloids intraoperatively. Placental vessels were visualized invading the bladder dome serosa anteriorly. Pathology confirmed placenta increta, maternal and fetal vascular malperfusion, and a 3-vessel cord with marginal insertion. On postoperative day (POD) 0, she was diagnosed with chronic hypertension with superimposed severe preeclampsia. On POD 1, she again developed hypoxia and pulmonary edema. One MFM specialist suggested her hypertension and pulmonary edema were likely due to volume overload rather than severe preeclampsia. She was discharged home on POD 4. Her baby was doing well in the NICU. On POD 9, the patient returned with a 1 cm area of superficial wound dehiscence, serosanguineous discharge, induration, erythema, and a leukocytosis of 17,000 cells/µL. Wound culture grew Serratia marcescens, and she was treated with antibiotics. At her six-week postpartum visit, her wound was closed and the visit was unremarkable. Conclusions: CSEP is rare type of ectopic pregnancy with significant maternal morbidity and mortality risk. Scar tissue from a prior cesarean delivery is weaker and less vascular than the surrounding uterine wall. In rare cases, a CSEP embryo may have a heartbeat, leading to a difficult decision to either terminate the pregnancy or accept serious risks including hemorrhage, uterine rupture, PAS, cesarean hysterectomy. If expectant management is chosen, a multimodal team is essential to ensure the patient is receiving appropriate management.

Diabetes self-management education (DSME) programs are evidence-based interventions that improve glycemic control and self-care behaviors, yet their effectiveness may be limited by unaddressed health-related social needs (HRSN) (e.g., food insecurity, housing or utility instability, transportation barriers). This qualitative multiple case study examined the feasibility of integrating HRSN assessments into DSME delivery within three community-based organizations (CBOs) across urban and rural U.S. settings. Guided by the Consolidated Framework for Implementation Research, semi-structured interviews were conducted with 15 DSME facilitators and program leadership to identify contextual factors influencing implementation. Findings revealed that while DSME's structured, manualized design promotes fidelity and client autonomy, it constrains responsiveness to the client's HRSN. Facilitators expressed openness to integrating HRSN screening, particularly during intake, yet cited limited infrastructure, role clarity, and training as key barriers. CBOs were recognized as trusted, accessible spaces for holistic care, but growing expectations to address HRSN without adequate resources for referral created sustainability concerns. Participants recommended a parallel support model involving navigators or community health workers to manage HRSN screening and referrals alongside DSME sessions. Integrating HRSN assessment processes into DSME may enhance engagement, reduce attrition, and extend the reach of diabetes education to populations most affected by HRSN. However, successful implementation requires dedicated funding, workforce development, and cross-sector coordination. Findings underscore the importance of supporting CBOs as critical partners in bridging diabetes education and social care to advance whole-person, chronic disease management.

To identify meaningful clusters of participants with shared baseline characteristics (demographic, clinical, and psychological) from a sample of adults with type 1 diabetes (T1D) completing dose adjustment for normal eating (DAFNE) structured T1D education, or the updated DAFNEplus programme. Further, to determine whether those clusters respond differently, at 6- and 12 months, to DAFNE and DAFNEplus on core outcomes: HbA1c and diabetes-specific quality of life (QoL). Latent profile analysis was conducted on the DAFNEplus randomised control trial dataset using relevant indicator variables (age; HbA1c; hypoglycaemia awareness; diabetes-specific QoL, distress, and positive well-being; fear of hypoglycaemia; satisfaction with diabetes management). Model fit indices were used to select the optimal number of clusters and multilevel linear regression models to estimate the effect of DAFNEplus (compared with DAFNE) on HbA1c and diabetes-specific QoL in each cluster. A total of n = 363 participants were included in the analysis (n = 147, 40% randomised to DAFNEplus). The final model included two clusters: the first was consistently worse off on clinical and psychological indicator variables. The multilevel analysis showed a significant adjusted mean difference, at 12 months (first cluster only), between DAFNE and DAFNEplus in diabetes-specific QoL (0.81; 95% CI: 0.19-1.43; p = 0.01), but not at other time points or in HbA1c. This study suggests that DAFNEplus has significant added benefits in reducing the negative impact of diabetes on QoL for a subgroup of adults with T1D, but not for their HbA1c. This provides important insights for the future real-world implementation of the DAFNEplus programme.

ABSTRACTBackground and AimsIdentifying the health‐related risk factors for COVID‐19 may improve future prevention strategies. This study aimed to investigate the association between pre‐pandemic health‐related factors and the prevalence and severity of COVID‐19 using data from the Sabzevar center of the PERSIAN cohort study.MethodsThis retrospective cohort study included 4241 individuals aged 35–70 from the Sabzevar PERSIAN cohort. Health‐related baseline data (demographic, anthropometric, biochemical, and chronic disease history) collected between 2017 and 2018 were linked with SARS‐CoV‐2 PCR test results and clinical outcomes (outpatient, hospitalization, or ICU admission/death) recorded in the health information system (HIS) between 2019 and early 2021. Descriptive and inferential statistical analyses were performed using t‐test, ANOVA, and Chi‐square tests.ResultsSARS‐CoV‐2 positivity was confirmed in 423 individuals (10%). Diabetes and lower education levels were significantly associated with SARS‐CoV‐2 infection (p < 0.05). Severity of disease was significantly higher among individuals aged ≥ 60, those with higher BMI, lower education, and comorbidities such as thyroid and ischemic heart disease. Baseline biochemical markers such as WBC, FBS, TG, and cholesterol levels were also associated with increased disease severity (p < 0.05).ConclusionPre‐existing health‐related factors—especially chronic diseases and demographic characteristics like age and education—are associated with both the likelihood of infection and the severity of COVID‐19. These findings highlight the importance of targeted preventive strategies for at‐risk populations, particularly the elderly and those with underlying conditions.

Continuous glucose monitoring (CGM) has been associated with improved glycemic control in individuals with non-insulin-treated type 2 diabetes (T2D), but adoption in endocrinology clinics remains limited. This quality improvement (QI) project aimed to explore the use of CGM for non-insulin-treated patients with T2D within an endocrinology clinic in Los Angeles County and to evaluate feasibility of its adoption in this practice setting. It was a retrospective chart review. Eligible patients were adults (≥18 years) with T2D and hemoglobin A1c (HbA1c) >7% who had not been treated with insulin. Ten patients met inclusion criteria. Descriptive statistics summarized HbA1c and time-in-range (TIR) over 6 months. An interrupted time series was also conducted on two patients with sufficient longitudinal data to assess HbA1c changes before and after CGM use. After 6 months of initial CGM use, 8 of 9 patients achieved HbA1c reductions of ≥0.3%. One patient demonstrated a ≥8% increase in TIR with adequate device use. Interrupted time series analyses illustrated individual HbA1c trajectories, showing immediate reductions after CGM initiation and nonsignificant downward trends over time. This QI project showed that patients with T2D treated with noninsulin medications successfully initiated and used CGM. Early improvements in HbA1c were observed; however, sustained glycemic outcomes varied depending on consistent CGM wear and adherence to follow-up, underscoring the need for individualized support. Nurse practitioners can play a key role in promoting sustained CGM use through structured diabetes education, integration of CGM data into lifestyle counseling, and regular follow-up.

Background: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications of pregnancy, and its prevalence continues to rise worldwide. Dietary management is the cornerstone of therapy, yet adherence may impose a substantial everyday burden. This study aimed to assess perceived burden and practical challenges related to following a diabetic diet in women with GDM. Methods: A cross-sectional anonymous online questionnaire study was conducted among 109 women with a current or past diagnosis of GDM within the previous five years. The survey addressed self-reported difficulties in maintaining normal blood glucose levels, adherence to a diabetic diet, perceived increases in grocery expenses, time required for meal preparation, dietary preferences, and family attitudes toward the diet. Associations between categorical variables were analyzed using contingency tables and the contingency coefficient. Results: Women with insulin-treated GDM (GDM2) reported more difficulties maintaining normal blood glucose levels than women treated with diet and physical activity alone (GDM1) (p = 0.014). Educational level was associated with perceived financial burden (p = 0.013) and meal preparation time (p = 0.003). These patterns likely reflect both differences in economic resources and the extent of dietary changes undertaken, rather than uniform differences in nutritional awareness. Pregnancy status was associated with dietary preferences, as non-pregnant respondents more often reported liking diabetic-diet meals than pregnant respondents (p = 0.037). Overall, 53.2% of respondents reported that a diabetic diet made daily functioning more difficult, mainly due to increased time and financial demands. Conclusions: Dietary management of GDM is associated with a meaningful perceived burden, especially among women requiring insulin therapy and those facing financial and time constraints. Understanding these subjective challenges may support more individualized dietary counseling and patient-centered care.

The perspectives of diabetes educators on the provision of type 1 diabetes education in schools; a comparison across geographical regions of Australia.

Background: Diabetes mellitus (DM) is a metabolic disorder in which inadequacy of insulin compromises the oxidization of glucose. Currently, DM affects more than 500 million people globally, about 9 million of whom live with Type 1 DM. DM causes several microvascular complications, one of which is diabetic ketoacidosis (DKA), a condition characterized by relative or complete insulin deficiency, making cells incapable of absorbing insulin. While there has been adequate research focusing on DM and its prevalence, little literature has focused on general knowledge and attitudes toward DKA, especially among DM patients in Saudi Arabia. Methods: This study adopted a cross-sectional research design to assess the knowledge and attitudes toward diabetic ketoacidosis (DKA) among diabetic patients in Saudi Arabia. The study was conducted between August 2024 and November 2024. It targeted adult diabetic patients, both male and female, in Saudi Arabia who had been diagnosed with diabetes (Type 1 or Type 2). A non -probability convenience sampling method was employed, resulting in a sample of 200 participants. Data were collected using an online survey (Google Forms) distributed via social media platforms, diabetes support groups, and healthcare institutions. The collected data were coded and analyzed using IBM SPSS version 27. Results: Results revealed that over half (55.8%) had heard of DKA, yet significant knowledge gaps remain, as 34% were unaware of its causes. Poor blood glucose control (50%) and missed insulin doses (28.8%) were identified as primary causes. While 68.6% believed DKA is preventable, only 40.4% knew the recommended frequency for blood sugar monitoring. Attitudes were generally positive, with 90.4% expressing interest in further education. Male participants and those receiving diabetes education demonstrated significantly higher knowledge levels (p = 0.040, p = 0.001, respectively). Conclusion: The study noted a statistically significant relationship between diabetes education and knowledge levels among Saudi diabetic patients, with educated persons having greater knowledge levels. Gender may also play a great role, implying that improving female diabetes education could help with diabetes management.

Understanding factors influencing medication adherence in Type 2 diabetes guided by the COM-B behaviour change model and assessed using the Morisky scale: A systematic review.

Wireless Sensor Networks (WSN) consist of miniature sensor nodes that communicate among themselves via wireless channels, often in an unfriendly environment, and nodes can be carried and defeated. Thus, an enemy may also attack the clones by copying the nodes taken and broadening the breaching areas with the help of clones. Hence, to reduce the losses of clone nodes to the WSNs, it is crucial to detect them as soon as possible. Other types of clone detection systems have been proposed in the recent past for WSNs, bearing in mind the dissimilar types of network structures, such as deployment strategies and types of devices. The Deep Learning (DL) techniques, however, are used to identify and clone nodes in WSN. A Hybrid Optimization Based Feature Learning is presented in this paper regarding Clone Detection Using Ensemble Learning Models (HOFLCD ELM). The project seeks to create and assess an effective clone detection technique in wireless sensor networks to improve network security and integrity. The initial phase of data preprocessing is the min-max normalization approach, which transforms raw data into a usable format for modeling. In the feature subset selection procedure, the proposed HOFLCD-ELM model develops a hybrid optimization process in the form of Lyrebat Algorithm (LYBA) that integrates Lyrebird Optimization Algorithm (LOA) and Bat Algorithm (BA) in order to find the optimal features within a dataset. Subsequently, the system of Deep Belief Network (DBN) model, Convolutional Variational Autoencoder (CVAE) method, and Graph Convolutional Network (GCN) has been implemented to identify and classify clone attacks. Lastly, the optimization process of the Spider Wasp (SWO) model is used to acquire the parameter tuning process in enhancing the classification of the ensemble classifier. The experimental analysis of the HOFLCD-ELM model is done through a benchmark and a dataset. The results of the empirical study showed that the performance of the HOFLCD-ELM method was improved more than that of the current methods.

The aim of this study was to explore the acceptability of an educational video among primary care clinicians as a tool to promote the use of stigma-free language in interactions with individuals with type 2 diabetes (T2D). The language used by primary care clinicians in interactions with adults living with T2D can contribute to perceptions and experiences of diabetes-related stigma and be a barrier to achieving and sustaining glycaemic targets. In 2017, the American Diabetes Association (ADA) and the Association for Diabetes Care & Education Specialists (ADCES) issued a guidance paper with recommendations to promote stigma-free communication about diabetes. The educational video, developed by the research team, presents two versions of a vignette in which a nurse practitioner interacts with an adult with T2D in a primary care setting. The first version of the vignette features the nurse practitioner using stigmatizing language as outlined in the ADA and ADCES guidance paper; the second demonstrates the use of stigma-free language by the nurse practitioner. A narrator highlights the linguistic differences. The study participants, comprising physicians (n = 8), nurse practitioners (n = 9), and physician assistants (n = 1), were recruited through professional networks and via online forums and listservs for healthcare professionals. Participants viewed the educational video and were interviewed via Zoom by a research team member using a semi-structured interview guide. The transcripts of the interviews were analysed using a qualitative descriptive approach. Three main themes emerged from the data: aligning video content with existing attitudes and beliefs, reducing the use of stigmatizing language, and increasing the use of stigma-free language. Findings suggest that an educational video promoting the use of stigma-free language in interactions with adults with T2D is acceptable among primary care clinicians.

Diabetes Mellitus is a chronic disease that requires long-term management. Low treatment motivation among patients often becomes an obstacle to successful therapy. Educational interventions have been shown to improve patients’ understanding and motivation in undergoing treatment. To determine the effect of diabetes education on treatment motivation among patients with Diabetes Mellitus. This study employed a quantitative design using a one-group pre–post test model. A total of 83 respondents were selected using purposive sampling. The instrument used was a motivation questionnaire that had been tested for validity and reliability. Data were analyzed using the Wilcoxon Signed Rank Test (α = 0.05). Most respondents had moderate motivation before receiving education (98.8%), while only a small proportion had low motivation (1.2%). After the educational intervention, motivation increased, indicated by the rise in the high-motivation category to 41.0% and the decrease in the moderate category to 59.0%. Comparison of pretest and posttest scores showed that 67.5% of respondents experienced increased motivation, 24.1% experienced a decrease, and 8.4% showed no change. The Wilcoxon test produced a significance value of 0.000 (p &lt; 0.05), indicating a significant difference between motivation before and after education.

BackgroundType 2 diabetes (T2D) presents a significant challenge to health systems and its prevalence is projected to increase. T2D is significantly influenced by lifestyle factors, including diet and physical activity. This makes therapeutic patient education (TPE) a pivotal component of T2D treatment strategies. While in some countries, like Germany and the UK, TPE elements like physician counselling regarding lifestyle changes (e.g., nutrition, smoking, exercise) and participation in diabetes education courses are part of structured nationwide disease management programs; in Switzerland, TPE elements are rarely part of the standard of care protocols. Our goal is to evaluate whether an interdisciplinary and individualized T2D program including TPE elements improves patients’ health outcomes.MethodsThe study is a multi-center cluster randomized controlled trial in the canton of Geneva in Western Switzerland. We aim to include a minimum of 154 recently diagnosed T2D patients from around 30 primary care physician (PCP) practices. Practices are randomized with a 1:1 patient allocation ratio to either intervention or control group using covariate constrained randomization. The intervention lasts 12 months with a 6-month follow-up and consists of two steps. First, PCPs in the intervention group and associated healthcare professionals (e.g., dieticians, physical therapists) are trained in interprofessional group sessions on TPE elements by specialists. Second, patients follow an individualized treatment plan which is designed within an initial quality circle with their PCP, other healthcare professionals, a TPE specialist, a dedicated study manager, and other patients. The treatment plan is accompanied by regular patient-reported outcome measure (PROM) collections, which are discussed in patients’ regular PCP visits. Patients in the control group follow standard of care. Primary endpoint is the 12 months mean change in HbA1c levels, secondary endpoints are the 18 months mean change in HbA1c levels, the 12 and 18 months mean changes in patient-reported outcomes (EQ-5D-5L, DIAB-Q), mean changes in medical outcomes (blood pressure, body composition, medication intake), and patient experience. We further evaluate cost-effectiveness from the payer perspective.DiscussionA positive evaluation of the study can inform a wider roll-out of the T2D program within Switzerland and be a cornerstone for better patient health outcomes for T2D patients.Trial registrationClinicalTrials.gov: NCT06774950. Registered on 14 January 2025Supplementary InformationThe online version contains supplementary material available at 10.1186/s13063-025-09302-x.