Table of Contents
September 03, 2025
3 min read
Key takeaways:
Adults with diabetes reported having better self-management skills following an education program involving a caregiver.
Diabetes distress scores significantly decreased for participants after the program ended.
A novel diabetes self-management education and support program that included active involvement from caregivers significantly improved self-management for people with diabetes, according to a speaker.
During a presentation at the Association for Diabetes Care & Education Specialists annual meeting, Ninfa Peña-Purcell, PhD, MCHES, senior research scientist at Texas A&M Center for Community Health and Aging, said people with diabetes and their family or support system should be the center of any diabetes care model, and the American Diabetes Association encourages the involvement of family members and caregivers in diabetes self-management education and support programs.
Data were derived from Peña-Purcell N, et al. Presentation S11C. Presented at: ADCES25; Aug. 8-11, 2025; Phoenix.
“A family member or friend can be leveraged to motivate behavior change in a person with diabetes, and a support system can buffer diabetes-related stress,” Peña-Purcell said during a presentation. “Social factors such as insufficient family involvement can negatively impact diabetes outcomes, but a family member or even a close friend can provide personalized ongoing health management and support.”
A novel education program
How a caregiver supports a person with diabetes is important, Peña-Purcell said. She discussed an autonomous support model that values the perspective of a person with diabetes, affirms confidence, promotes intrinsic motivation, provides options for the person with diabetes and encourages them to engage in self-care behaviors.
Peña-Purcell added that traditional diabetes self-management education and support programs often do not actively involve caregivers. This led to the creation of Live in Control, a novel 4-week family-centered diabetes self-management education and support program consisting of 2-hour weekly sessions that a person with diabetes attends alongside a caregiver. Peña-Purcell said the caregivers, which she defined as “care supporters” in the program, have an active role in the sessions.
In a pilot study that was also published in The Science of Diabetes Self-Management and Care, researchers enrolled 49 adults older than 35 years with type 2 diabetes who were struggling with their glycemic control and had a family member or friend who could attend weekly sessions with them (mean age, 66 years; 69.4% women; 49% white). Participants enrolled in Live in Control after attending an orientation session. The program lasted for 4 weeks, with each weekly meeting focused on a different lesson. The lessons included steps to control diabetes, how to maintain safe glucose levels, healthy eating habits and how to prevent diabetes complications.
“The novel approach is the care supporter in that program,” Peña-Purcell said. “We designed that program to involve them in an intentional way where the person with diabetes comes to the program, they have their activities, and they also have take-home activities. [For] the care supporter it is the same, and in the lessons we have opportunities for care supporters and their loved one with diabetes to pair up and do activities [together].”
Follow-up occurred at 4 and 12 weeks. The Diabetes Self-Management Questionnaire was administered to measure self-care behaviors, with a higher score indicating better diabetes self-management. The Self-Efficacy for Diabetes scale assessed one’s confidence in self-management, with a higher score indicating greater self-efficacy. Autonomy support, social support and diabetes distress were also evaluated through questionnaires.
Study results
Of the participants, 42 adults completed the intervention at 4 weeks and 36 had follow-up data collected at 12 weeks.
Diabetes self-management scores increased from 6.13 points at baseline to 6.98 points at 4 weeks (P < .01) and 7.35 points at 12 weeks (P < .01). Self-efficacy rose from 2.71 points at baseline to 3.28 points at 4 weeks (P < .01) and 3.1 points at 12 weeks (P = .02). The change in both scores from 4 weeks to 12 weeks was not significant.
Autonomy support scores improved from 4.87 points at baseline to 5.59 points at 12 weeks (P < .01), and social support scores increased from 2.8 points at baseline to 3.34 points at 12 weeks (P = .01). Diabetes distress scores fell from 2.6 points at baseline to 1.99 points at 12 weeks (P < .01).
Mean HbA1c decreased slightly from 7.39% at baseline to 7.21% at 12 weeks. Peña-Purcell noted that the HbA1c change for the full study group was not significant, but a significant reduction in HbA1c was observed for adults who had an HbA1c of more than 8% at baseline.
“Increased autonomy support is critical in [diabetes self-management education and support],” Peña-Purcell said. “That’s not just passive support, but providing skills for that person with diabetes’ loved one to take home, learn and apply so they can provide constructive support.”
Reference:
Peña-Purcell NC, et al. Sci Diabetes Self Manag Care. 2025;doi:10.1177/26350106251320327.
Sources/Disclosures
Collapse
Source:
Peña-Purcell N, et al. Presentation S11C. Presented at: ADCES25; Aug. 8-11, 2025; Phoenix.
Disclosures:
Peña-Purcell reports no relevant financial disclosures.
