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The use of a mobile application could be a valuable resource for providing ongoing self-management education and support for people with diabetes. This study is the first in Thailand to assess the efficacy of insulin injection education via mobile messenger applications in adults with type 2 diabetes. An open-label, randomized, three-armed study was conducted. Group 1 (n = 27) received an individual insulin injection education session from a diabetic educator. Group 2 (n = 26) received an initial insulin injection education session in the same manner as group 1, then messages regarding insulin injection knowledge were sent via messenger application twice a week for 3 months consecutively. Group control (n = 27) received only routine care. The primary endpoint was the difference in hemoglobin A1c from baseline to month 6 after the intervention. Outcomes included changes in fasting plasma glucose, and knowledge scores on insulin injection were also evaluated.
Results indicated that participants in both group 2 and group 1 showed a significant reduction in hemoglobin A1c at 6 months compared to controls. However, hemoglobin A1c reduction between groups 2 and group 1 showed no statistical significance. In terms of scores on knowledge of insulin injection, results indicated that the increase in scores on knowledge at 6 months in group 2 was greater than both the control and group 1. This finding demonstrated that insulin injection education is important to improve glycemic control in insulin-treated type 2 diabetes, regardless of delivery methods. Despite no significant difference compared to the education session in terms of glycemic control, a mobile messenger education should be considered as one of the effective interventions in improving knowledge scores on insulin injection. Also, nurses can facilitate ongoing coaching by using smartphones and mobile communication applications, which are easy to use and follow-up in diabetes education.
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