Effects of therapeutic education on self-efficacy, self-care activities and glycemic control of type 2 diabetic patients in a primary healthcare center in Lebanon



Diabetes type 2 is a chronic hyperglycemia, its control depends on the patient’s Self-efficacy and self-care activities. Therapeutic Patient Education (TPE) enhances the patient involvement and engagement in managing chronic diseases effectively by improving the health outcomes. It helps the patients developing competencies of self-care, coping with diabetes and controlling glycaemia.


The objectives of this study are to assess the effects of TPE in type 2 Diabetic patients in Lebanon on their glycemic control, Diabetes Management Self-Efficacy Scale (DMSES) and their self-care activities (Summary of Diabetes Self-Care Activities SDSCA).

Materials and methods

A total of 100 diabetic patients (50 experimental, 50 control) were recruited from a primary care center according to inclusion and exclusion criteria. The experimental group followed the TPE by a multidisciplinary team. Glycemic control, DMSES and SDSCA were measured at baseline and after three months. The experimental group (EG) was followed up by phone calls every two weeks after the TPE.


The results revealed that the experimental group showed significant improvement at the level of self-efficacy in managing their disease concerning general nutrition, specific nutrition, control of glycaemia, physical activity, weight control and medical control (α<0.01); the total score of DMSES had significantly increased from 5.02 to 8.28 in the EG (α<0.01) compared to the control group (CG) that has decreased from 4.91 to 4.85 (α<0.05). Moreover, regarding the SDSCA of the EG, the results highlighted that the activities related to general diet, specific diet, physical exercise, foot care, the measurement of glycaemia and the medication-taking had significantly improved (α<0.05), whereas the CG didn’t improve his self-care activities (α>0.05). In addition, the glycemic control HbA1c had improved in the EG after the intervention compared to the CG.


The findings of this study demonstrated that Therapeutic Patient Education is efficient in contributing to better glycemic control, better DMSES and SDSCA. Health professionals are best suited to help diabetic patients improve their self-efficacy in managing diabetes, controlling glycemia and improving their self-care.

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Availability of data materials

The data and materials are available with the author. Kindly contact her for data requests.



Body Mass Index


Control Group


Diabetes Management Self-Efficacy Scale


Type 2 Diabetes


Experimental Group


Highly Significant


Not Significant


Primary Healthcare Center




Summary of Diabetes Self-Care Activities




Statistical Package for Social Sciences


Therapeutic Patient Education


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The author would like to thank the director and the staff of the primary healthcare center, the endocrinologist and the study participants, Johnson and Johnson, as well as the thesis advisor Pr. Marc Weisser Emeritus Professor at University Haute Alsace, Mulhouse France, and the administration of Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, Lebanon, for their support.


This research was funded by the researcher.

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The author is responsible for the design of the study, data collection, data analysis and manuscript writing.

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Correspondence to Najwa S. ElGerges.

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ElGerges, N.S. Effects of therapeutic education on self-efficacy, self-care activities and glycemic control of type 2 diabetic patients in a primary healthcare center in Lebanon. J Diabetes Metab Disord 19, 813–821 (2020). https://doi.org/10.1007/s40200-020-00567-4

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  • Diabetes type 2
  • Diabetes self-efficacy
  • Self-care
  • Glycemic control
  • HbA1c
  • Lebanon