The science of diabetes self-management and care最新文献

{"title":"Application of the Information-Motivation-Behavioral Skills Model of Medication-Taking Behavior in People With Diabetes.","authors":"Shinae Seo, Hee Sun Kang, Chun-Ja Kim, Elizabeth A Schlenk","doi":"10.1177/26350106261434496","DOIUrl":"https://doi.org/10.1177/26350106261434496","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to examine a hypothetical model of medication-taking behavior in individuals with type 2 diabetes based on the information-motivation-behavioral skills (IMB) model and to investigate pathways depending on the presence of depressive symptoms.</p><p><strong>Methods: </strong>This study employed a theory-driven, cross-sectional correlational design and used path analysis to examine the hypothesized relationships. Participants comprised 325 adults with type 2 diabetes mellitus who attended a university-affiliated hospital in South Korea. Structured questionnaires were used to measure IMB-model-driven variables: medication knowledge (information), health beliefs about medication (cognitive motivation), depressive symptoms (affective motivation), medication self-efficacy (behavioral skills), and medication-taking behavior (behavioral change). Path analysis was conducted using AMOS 26.0, and multigroup analysis examined structural pathway differences between individuals with and without depressive symptoms.</p><p><strong>Results: </strong>Medication self-efficacy and health beliefs about medication directly influenced medication-taking behavior, and depressive symptoms had an indirect effect through self-efficacy. The path from medication self-efficacy to medication-taking behavior was significantly stronger among individuals with depressive symptoms compared to those without depressive symptoms.</p><p><strong>Conclusions: </strong>The findings provide empirical support for the model, demonstrating that behavioral skills are a crucial mediator in the relationships between motivation and medication-taking behavior.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"26350106261434496"},"PeriodicalIF":2.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural Perceptions and Diabetes Self-Care in Filipino Americans With Type 2 Diabetes: An Integrative Review for Diabetes Care and Education Specialists.","authors":"Rachell Nguyen","doi":"10.1177/26350106261438815","DOIUrl":"https://doi.org/10.1177/26350106261438815","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this integrative literature review was to synthesize quantitative and qualitative evidence describing the impact of cultural perceptions on diabetes self-care behaviors among Filipino American adults with type 2 diabetes (T2DM), identifying knowledge gaps and generating practice implications for diabetes care and education specialists.</p><p><strong>Methods: </strong>Using Whittemore and Knafl's integrative review framework, 4 databases (CINAHL, PubMed, Medline, and ScienceDirect) were searched for English-language studies published from 2000 to 2025. Inclusion criteria included empirical studies examining cultural factors, classified as (1) family-centered values (e.g., bayanihan, pakikisama), (2) traditional food practices, (3) spirituality and fatalism, (4) acculturation and colonial mentality, and (5) community support networks and at least 1 ADCES7 self-care behavior in Filipino American adults with T2DM. Methodological quality was evaluated using the Johns Hopkins evidence-based practice tool. Data were extracted into standardized matrices and analyzed through constant comparative analysis.</p><p><strong>Results: </strong>Nine studies (6 quantitative, 3 qualitative) identified 5 cultural domains that facilitated or hindered ADCES7 behaviors, including healthy eating, medication adherence, and blood glucose monitoring. Evidence strength ranged from Level II to Level III.</p><p><strong>Conclusions: </strong>Diabetes care and education specialists must assess these 5 cultural domains, incorporating family involvement, culturally appropriate nutrition counseling, spiritual considerations, and community-based support, to enhance ADCES7 self-care behaviors.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"26350106261438815"},"PeriodicalIF":2.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition to Virtual Diabetes Self-Management Education Delivery in the Setting of Health Care Disruption for Adults With Diabetes and Their Support Persons.","authors":"Denise J Deverts, Margaret F Zupa, Edith C Kieffer, Gretchen A Piatt, Michele Heisler, Felix Valbuena, Stephanie Gonzalez, Claudia Guajardo, Jonathan G Yabes, Christina Lalama, Ann-Marie Rosland","doi":"10.1177/26350106261432172","DOIUrl":"https://doi.org/10.1177/26350106261432172","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to describe adaptations and participant characteristics and engagement in family-focused diabetes self-management education (DSME) before and during a large-scale disruption in health care access and research participation, which prompted a pivot to virtual DSME.</p><p><strong>Methods: </strong>The study was conducted at a federally qualified health center (FQHC) serving a predominantly low-socioeconomic status Hispanic community. Two hundred twenty-two adults with type 2 diabetes (85% Hispanic) receiving care from the FQHC enrolled with a support person (SP); dyads were randomized to community health worker (CHW)-led dyad-focused Family Support for Diabetes Health Action (FAM-ACT) or patient-focused DSME. Survey, health record, and session data were compared between those enrolled before (n = 77) versus during the disruption (n = 145).</p><p><strong>Results: </strong>In hybrid (virtual+in person) DSME, CHWs prioritized group discussion and shorter sessions emphasizing participants' personal health goals and social-emotional concerns. Enrollment was lower after versus before switching to hybrid (23% vs 30% recruited). Those with less complex diabetes and preferring Spanish enrolled at higher rates during hybrid offerings. Overall, patient DSME attendance slightly decreased during versus before hybrid implementation (mean -0.3 sessions/6) but increased in FAM-ACT patients (mean +0.3 sessions/6) and SPs (mean +0.5 sessions/6). During hybrid programs, patients choosing virtual attendance were more often female, living with children, have food insecurity and difficulty prioritizing diabetes over other demands.</p><p><strong>Conclusions: </strong>Group DSME delivered via hybrid sessions maintained participant engagement during a large-scale disruption in health care access by addressing language, health and social needs, life demands, and technological barriers.</p><p><strong>Trial registry: </strong>The underlying trial was registered with www.</p><p><strong>Clinicaltrials: </strong>gov (NCT03812614, 01/18/2019).</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"26350106261432172"},"PeriodicalIF":2.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Pharmacist-Led Service to Expand SGLT2 Inhibitor Use Beyond Diabetes in the Primary Care Setting.","authors":"Stacey Cutrell, Kiara Patino, R Oluwafunmito Babalola, Michael Murchie, John D Bucheit","doi":"10.1177/26350106261431283","DOIUrl":"https://doi.org/10.1177/26350106261431283","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this report is to evaluate the impact of a pharmacist-led quality improvement initiative on the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors in patients with chronic kidney disease (CKD) and heart failure (HF) at a primary care clinic.</p><p><strong>Methods: </strong>As part of a pharmacist-led quality improvement initiative between March 1, 2022, and March 1, 2023, patients with CKD and HF were considered for SGLT2 inhibitor therapy by a primary care provider or referred to the pharmacy team for potential initiation of treatment using a collaborative practice agreement. The pharmacy team was led by a diabetes care and education specialist (DCES) who regularly manages drug therapy, including SGLT2 inhibitors, for people with diabetes. Predefined criteria for appropriate SGLT2 inhibitor use in patients with CKD and HF was developed to identify eligible patients. The primary outcome of this initiative was the change in the proportion of patients appropriately receiving SGLT2 inhibitor therapy.</p><p><strong>Results: </strong>A total of 71 patients met treatment criteria. Of the 71 patients identified, 57 were not receiving treatment at baseline. By the end of the initiative, the proportion of patients receiving SGLT2 inhibitor therapy increased from 19.7% to 50.7%. Treatment was initiated by the pharmacist in 64% of patients.</p><p><strong>Conclusion: </strong>This initiative resulted in a significant improvement in SGLT2 inhibitor use for patients with CKD and HF. The findings highlight the feasibility of using DCES-credentialed pharmacists in an interprofessional care team to initiate SGLT2 inhibitor therapy for patients with these conditions in the primary care setting.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"26350106261431283"},"PeriodicalIF":2.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Dental Care Is Not My Priority\": A Descriptive Qualitative Study of Experiences and Support Needs for Oral Health Self-Care in Older Adults With Type 2 Diabetes.","authors":"Yaocan Bao, Shanshuo Sun, Yixuan Su, Yuting Jiang, Leyan Yu, Jie Zhong, Yu Liu, Lingxia Ge, Wei Liang","doi":"10.1177/26350106261431267","DOIUrl":"https://doi.org/10.1177/26350106261431267","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to understand the experiences and support needs for oral health self-care among older adults with type 2 diabetes.</p><p><strong>Methods: </strong>From November 2024 to January 2025, a descriptive qualitative study was conducted in China through individual semistructured interviews. All interviews were audio recorded and transcribed verbatim. Data were analyzed using thematic analysis.</p><p><strong>Results: </strong>A total of 23 participants were recruited. The findings are described in 3 themes and 6 subthemes. The first theme, perception of oral health: dental care is not a top priority in the context of aging, contained two subthemes: oral health illness perception and the role of diabetes and reliance on personal experience with limited knowledge and education. The second theme, oral health self-care: focusing on alleviating symptoms in oral health decisions, contained two subthemes: symptom-driving management and passive coping and adapting to oral changes to minimize the interruptions. The third theme, unmet support needs: multifaceted barriers and expectations in managing oral health, contained two subthemes: barriers to oral health-seeking behaviors and expectations for support from multiple stakeholders.</p><p><strong>Conclusion: </strong>The findings highlight the need for tailored oral health self-care education and support. Incorporating effective, culturally appropriate oral care into routine diabetes management is recommended to ensure high-quality care.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"26350106261431267"},"PeriodicalIF":2.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Quality of TikTok-Based Diabetes Self-Management Education in English and Spanish: A Digital Health Study.","authors":"Lisa Diaz, Dante Anthony Tolentino, Mary-Lynn Brecht, Wendie Robbins, Sarah E Choi","doi":"10.1177/26350106261422680","DOIUrl":"10.1177/26350106261422680","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate TikTok videos about type 2 diabetes mellitus (T2DM) in English and Spanish, with a focus on the Association of Diabetes Care and Education Specialists' 7 self-care behaviors (ADCES7).</p><p><strong>Methods: </strong>This descriptive study analyzed 300 TikTok videos via English and Spanish hashtags related to T2DM and categorized self-management education content utilizing the ADCES7 self-care behavior framework. Video content creators were categorized into 3 groups: health care professionals, personal accounts, and companies. The Global Quality Scale (GQS) was used to assess video quality from 1 (poor) to 5 (excellent). User engagement metrics were recorded to examine differences across videos.</p><p><strong>Results: </strong>The analysis of videos revealed that healthy eating was the most frequently addressed ADCES7 self-care behavior, followed by reducing risk. In contrast, problem-solving and healthy coping were the least represented. Spanish-language videos emphasized healthy coping more than English content. Health care professionals' videos had higher GQS scores than personal accounts and companies. However, overall GQS scores remained low-engagement varied by source, with personal creators generating the highest levels of likes and comments.</p><p><strong>Conclusions: </strong>Traditional in-person diabetes education has limited accessibility, especially for various groups, including Hispanic communities. This study found that TikTok content often lacked high-quality and comprehensive coverage of ADCES7 self-care behaviors, with personal accounts generating the most engagement despite lower quality. Given TikTok's rapid growth, there is an urgent need to improve the quality of diabetes-management content to ensure users receive accurate and reliable information.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"150-161"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12996366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Work of Faith Care: An Interpretive Phenomenological Analysis on the Role of Spirituality and Religion in Diabetes Self-Management Among Black Older Adults in the Greater Toronto Area.","authors":"Kristina M Kokorelias, Chukwuebuka Prince Onyekere, Hardeep Singh, Sarah E P Munce, Sachindri Wijekoon, Michael E Kalu, Maurita T Harris","doi":"10.1177/26350106261422687","DOIUrl":"10.1177/26350106261422687","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to explore how faith and spirituality influence diabetes self-management among older Black adults with type 2 diabetes.</p><p><strong>Methods: </strong>The researchers conducted in-depth interviews with 21 older Black adults (ages 55+) living with type 2 diabetes or prediabetes in the Greater Toronto Area. Guided by Van Manen's interpretive phenomenology and analyzed thematically using NVivo, the researchers examined lived experiences through 4 lifeworld themes: corporeality, spatiality, relationality, and temporality.</p><p><strong>Results: </strong>Four themes emerged: faith as inner strength (spiritual resilience), sanctuaries of the soul (sacred spaces for healing), guided by faith (faith in relationships and community), and faith through time (spiritual continuity and hope). Faith helped participants manage stress, regulate emotions, sustain self-care, and strengthen social and familial bonds while providing hope across the course of illness.</p><p><strong>Conclusion: </strong>Spirituality serves as a multidimensional resource in culturally responsive, person-centered diabetes care. Integrating faith-based perspectives into interventions can foster more holistic, contextually grounded approaches that enhance well-being and long-term adherence to self-management.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"113-123"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12996361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Structured Physical Exercise Program and Medication on Glycemic Control in Type 2 Diabetes Mellitus in Bangladesh: A Randomized Controlled Trial.","authors":"Suraiya Yesmin Sharna, Kazi Md Azman Hossain, Md Feroz Kabir, Md Zahid Hossain, Sharmila Jahan, Ehsanur Rahman, Kazi Md Amran Hossain","doi":"10.1177/26350106261422666","DOIUrl":"10.1177/26350106261422666","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to investigate the effects of a 6-week physiotherapist-led structured physical exercise program (SPEP) alongside routine medication on glycemic control, physical fitness, and quality of life in adults with type 2 diabetes mellitus (T2DM) in Bangladesh.</p><p><strong>Methods: </strong>Ninety adults with T2DM for over 3 years were randomly assigned to an experimental (n = 45) or control group (n = 45). The experimental group performed 3 supervised SPEP sessions per week plus prescribed medication, and the control group continued routine medication with lifestyle guidance for 6 weeks. Glycemic control, assessed by capillary blood glucose (CBG), was the primary outcome. Secondary outcomes included physical fitness 6-minute walk test (6MWT), and quality of life (Short Form-36 [SF-36]). Assessments were conducted at baseline and postintervention by blinded assessors, and data were analyzed using the intention-to-treat principle.</p><p><strong>Results: </strong>Baseline characteristics were comparable. Both groups improved across outcomes, with greater gains in the experimental group, including reductions in CBG, increased 6MWT distance, and higher SF-36 scores. Adherence was high, and no serious adverse events occurred.</p><p><strong>Conclusions: </strong>Six weeks of physiotherapist-led SPEP added to routine medication improved glycemic control, physical fitness, and quality of life in adults with T2DM. These findings support the feasibility and short-term efficacy of structured exercise in this population. Future studies should assess long-term sustainability and metabolic benefits.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"138-149"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Effects of Diabetes-Specific and Overall Medication Regimen Complexity on Diabetes Distress.","authors":"Kaye Min Teo, Ryan J Shaw, Anastasia-Stefania Alexopoulos, Gina Pennington, Daniel Hatch, Qing Yang, Matthew J Crowley","doi":"10.1177/26350106261422676","DOIUrl":"10.1177/26350106261422676","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine the association between diabetes-specific and overall medication regimen complexity and diabetes distress among adults with type 2 diabetes.</p><p><strong>Methods: </strong>This study examined data from 220 patients with type 2 diabetes and hypertension and persistently elevated A1C, who were recruited for a remote monitoring-enabled telehealth trial (Clinicaltrials.gov NCT05120544). Chart review was performed to obtain prescription data to determine medication regimen complexity using the validated medication regimen complexity index. Multiple regression models were used to investigate the link between regimen complexity and Diabetes Distress Scale and subscale scores, adjusting for sociodemographic variables and comorbidities.</p><p><strong>Results: </strong>Study sample was 64% women, 68% Black, with a mean age of 54.5. The mean A1C was 9.8% (84 mmol/mol), and 63% reported moderate to high distress. The study population was prescribed a mean of 2.9 diabetes medications and 11.5 overall long-term medications. The mean diabetes-specific and overall Medication Regimen Complexity Index were 11.5 and 30.2, respectively. No statistically significant associations between diabetes-specific or overall medication regimen complexity and diabetes distress were identified. Overall medication regimen complexity was negatively associated with regimen-related diabetes distress. Medication regimen complexity did not significantly impact the association between diabetes distress and A1C.</p><p><strong>Conclusions: </strong>Participants with high overall medication regimen complexity had lower regimen-related diabetes distress. Further studies are needed to evaluate associations between medication regimen complexity and diabetes distress while ensuring sufficient statistical power.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"162-173"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feasibility of an Integrative Online Tai Chi Easy Intervention Plus a Diabetes Self-Management Education and Support Program.","authors":"Ruth E Taylor-Piliae, Meghan B Skiba, Carlie M Felion, Elise Dando, Shravan Aras, Chiu-Hsieh Paul Hsu, Julio Loya","doi":"10.1177/26350106261426277","DOIUrl":"10.1177/26350106261426277","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine the acceptability, appropriateness, and feasibility of adding a Tai Chi Easy (TCE) intervention to an asynchronously delivered online diabetes self-management education and support (DSMES) program for working adults ages 40 to 64 years old diagnosed with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>Participants attended the online intervention after providing informed consent. Recorded videos (45-minutes DSMES and 45-minutes TCE) were sent to participants via Research Electronic Data Capture twice weekly for 6 weeks. DSMES+TCE intervention acceptability, appropriateness, and feasibility was assessed postintervention using a validated tool. Using validated self-report measures and finger-worn sensors, physical health was assessed preintervention, and psychological health and health behaviors were assessed preintervention and postintervention.</p><p><strong>Results: </strong>Twenty-eight participants (mean age = 51, 68% females) completed the study. Participants mainly used diet and exercise (71%) and oral medication (75%) to treat their T2DM but had elevated A1C levels (6.74 ± 1.16) preintervention. Participants reported 89% acceptability, 85% appropriateness, and 100% feasibility of the online DSMES+TCE intervention. Compared to preintervention, there was a reduction in diabetes-related distress, depression, stressful life events, and perceived stress and greater diabetes quality of life postintervention. In addition, they increased their daily total fruit and vegetable intake, reduced added sugar intake, and increased daily sleep duration postintervention compared to preintervention.</p><p><strong>Conclusion: </strong>The addition of TCE to the standardized DSMES curriculum was found to be acceptable, appropriate, and feasible as a remotely delivered asynchronous online intervention for working adults ages 40 to 64 years with T2DM.</p>","PeriodicalId":75187,"journal":{"name":"The science of diabetes self-management and care","volume":" ","pages":"124-137"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}