Currently submitted to: Journal of Medical Internet Research
Date Submitted: May 28, 2026
Open Peer Review Period: Jun 19, 2026 - Aug 14, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Artificial Intelligence–Integrated Diabetes Self-Management Education and Its Impact on Glycemic Control, Self-Efficacy, and Hospital Readmission Among Adults with Type 2 Diabetes Mellitus.
ABSTRACT
Background:
Type 2 diabetes mellitus (T2DM) remains one of the leading chronic diseases contributing to morbidity, mortality, and healthcare burden globally. Although Diabetes Self-Management Education (DSME) has demonstrated positive outcomes, evidence regarding the integration of artificial intelligence (AI)-supported nursing education in Indonesian hospital settings remains limited, particularly in multicenter contexts.
Objective:
This study aimed to examine the effectiveness of Artificial Intelligence–Integrated Diabetes Self-Management Education (AI-DSME) on glycemic control, diabetes self-care behavior, self-efficacy, quality of life, and hospital readmission among adults with T2DM in several Type B hospitals in South Sulawesi, Indonesia.
Methods:
A multicenter prospective cohort study was conducted from February 2025 to February 2026 in five Type B hospitals across South Sulawesi Province, Indonesia. A total of 630 adult patients with T2DM were recruited using stratified proportional random sampling. Participants received nurse-led AI-assisted DSME interventions incorporating personalized mobile education, automated reminders, nutritional recommendations, medication adherence monitoring, and family-centered counseling. Data were collected at baseline, 3 months, 6 months, and 12 months using the Summary of Diabetes Self-Care Activities (SDSCA), Diabetes Management Self-Efficacy Scale (DMSES), EQ-5D-5L, glycated hemoglobin (HbA1c), and hospital readmission records. Multivariate generalized estimating equation analysis was performed.
Results:
The mean age of participants was 56.8 ± 10.7 years, and 58.4% were female. Significant improvements were identified in self-care behavior scores (β = 1.92; p < 0.001), self-efficacy (β = 2.14; p < 0.001), and quality of life (β = 1.38; p < 0.001). Mean HbA1c decreased from 9.1% ± 1.8 at baseline to 7.3% ± 1.2 at 12 months (p < 0.001). Hospital readmission rates declined from 21.7% to 8.9% during follow-up. AI-supported individualized education demonstrated stronger effects among participants with poor baseline glycemic control and low educational attainment.
Conclusions:
AI-integrated DSME significantly improved glycemic outcomes, self-care practices, quality of life, and reduced readmission among adults with T2DM. Integrating digital nursing interventions into hospital-based diabetes management programs may provide scalable and sustainable solutions for chronic disease management in low- and middle-income countries.
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