Effectiveness of an Intensive Lifestyle Modification Program for Achieving Diabetes Remission among Adults with Type 2 Diabetes in a Diabetes School, Mueang District, Buriram Province, Thailand

Abstract

Background: Diabetes remission is an emerging treatment goal for type 2 diabetes, aiming to achieve glycemic levels below the diagnostic threshold for diabetes without glucose-lowering medications, which may improve quality of life and reduce the risk of complications.
Objectives: To evaluate outcomes of an intensive lifestyle modification–based self-management program for adults with type 2 diabetes and to assess changes in diabetes-related knowledge.
Methods: This retrospective cohort study included adults (age ≥18 years) with type 2 diabetes receiving care at three community medical centers in Mueang District, Buriram Province, Thailand, from April 2024 to April 2025 (n=54). The 12-week diabetes school program provided structured education, follow-up, and repeated evaluation. Pre- and post-program data were compared using descriptive statistics and paired-sample t-tests.
Results: Most participants were female (68.5%) with a mean age of 55.0±4.9 years. Mean HbA1c decreased significantly from 8.5% to 7.6% (mean change -0.9%; p<0.001). Six participants (11.1%) achieved diabetes remission. Mean knowledge scores increased from 8.1 to 11.1 out of 15 (p<0.001).
Conclusions: The intensive lifestyle modification program implemented in the diabetes school in Mueang District, Buriram Province, significantly reduced HbA1c and improved diabetes-related knowledge, and 11.1% of participants achieved diabetes remission. These findings support adapting the program to strengthen diabetes care in other clinical settings.