Effectiveness of a theory-based tailored individual and family self-management education in adults with uncontrolled diabetes: A randomized controlled trial.

The trial only measured outcomes after 8 weeks, so it does not show whether the benefits last. HbA1c, the usual gold standard for glycemic control, was not measured, so the TyG index result cannot be treated as proof of improved long-term glucose control. The intervention was a bundle of education, group discussions, family calls, infographics, WhatsApp messages, work modules, and routine care, so the contribution of any single component cannot be separated. Participants knew their group because the intervention could not be concealed, which can affect self-reported outcomes. All participants were Javanese and Muslim and were recruited from community clinics in East Java, so the results may not apply to other settings. The trial analysed 68 dyads, and one control participant was lost to follow-up.

This work was supported by a Second Century Fund Chulalongkorn University postdoctoral fellow. The funder had no role in design, implementation, data collection, analysis, interpretation, or submission, and the authors declared no conflict of interest.

Do not conclude that family involvement or any single part of the program caused the improvement. The intervention was delivered as a bundle alongside routine care, and HbA1c was not measured, so the results do not prove that a specific component works or that glycemic control improved.