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. 2025 Mar 20;17(3):e80890.
doi: 10.7759/cureus.80890. eCollection 2025 Mar.

Evaluating the Impact of Individualized Interventions on Diabetes Distress and Glycemic Outcomes: A Shift From Glycated Hemoglobin (HbA1c) to Random Blood Sugar (RBS) in a Quasi-experimental Study

N L Swathi  1 , Venu Priyanka P  1 , Devadarshini M  1 , Adnaan Parvez Mohammed  1 , Jothieswari D  2 , Muhammad Umar  3 , Syed Muhammad Ali  4   5 , Javed Iqbal  6 , Pravallika P  7
Affiliations

Evaluating the Impact of Individualized Interventions on Diabetes Distress and Glycemic Outcomes: A Shift From Glycated Hemoglobin (HbA1c) to Random Blood Sugar (RBS) in a Quasi-experimental Study

N L Swathi et al. Cureus. .

Abstract

Background Diabetes distress (DD) is a significant barrier to effective diabetes management, impacting self-care behaviors and glycemic control. While most studies utilize glycated hemoglobin (HbA1c) as a standard marker for glycemic regulation, cost constraints often limit its availability. This study explores the shift from HbA1c to random blood sugar (RBS) as an alternative measure and assesses the impact of individualized interventions on DD and glycemic outcomes in individuals with uncontrolled type 2 diabetes mellitus (T2DM). Methods A quasi-experimental study was conducted on 180 participants aged 18-65 years, divided into an experimental group (n=82) receiving structured psychological and lifestyle counseling and a control group (n=98) receiving standard care. DD and RBS levels were recorded at baseline and after three months of the intervention. Statistical analyses included Pearson's correlation, student's t-test, and Wilcoxon signed-rank tests to evaluate changes in distress levels and glycemic control. Results Post-intervention, the experimental group showed a significant reduction in DD (t = 15.26, p < 0.001, Cohen's d = 1.685) and RBS (mean reduction = 10.68%), confirming the effectiveness of the structured interventions. The control group exhibited an unexpected increase in DD (t = -8.75, p < 0.001, Cohen's d = -0.960), whereas RBS remained largely unchanged (1.29% increase). A significant correlation (p = 0.000) between DD reduction and RBS improvement was observed. Conclusions Individualized interventions significantly reduced diabetes distress and improved glycemic outcomes, demonstrating that RBS may serve as a cost-effective alternative to HbA1c. Future research should focus on directly comparing RBS and HbA1c levels and evaluating the long-term sustainability of the intervention benefits across different age groups.

Keywords: diabetes distress; glycemic control; psychological intervention; random blood sugar; type 2 diabetes mellitus.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethical Committee issued approval IEC/RVSIMS/2023/05/06. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flow chart describing the study methodology
This flowchart outlines the study phases for evaluating diabetes distress (DDS) and random blood sugar (RBS) levels. A total of 180 participants were recruited and divided into control (n = 98) and experimental (n = 82) groups. Start-Up Phase: Baseline DDS and RBS values were collected. Continuity Phase: The control group received standard care while the experimental group received diet counseling and diabetes management guidance. Follow-Up Phase: DDS reassessments were conducted via telephone, with 83 control participants responding. Close-Up Phase: Post-intervention DDS and RBS values were recorded for statistical analysis.
Figure 2
Figure 2. Subject information documentation form
Figure 3
Figure 3. Subject information documentation form (Contd.)
Figure 4
Figure 4. Informed consent form in the native language (Telugu) and English
Figure 5
Figure 5. Informed consent form in the native language (Telugu) and English
Figure 6
Figure 6. Diet plan
Figure 7
Figure 7. Diet plan (Contd. 1)
Figure 8
Figure 8. Diet plan (Contd. 2)
Figure 9
Figure 9. Diet plan (Contd. 3)
Figure 10
Figure 10. Diet plan (Contd. 4)
Figure 11
Figure 11. Diet plan (Contd. 5)
Figure 12
Figure 12. Diet plan (Contd. 6)
Figure 13
Figure 13. Diet plan (Contd. 7)
Figure 14
Figure 14. Diet plan (Contd. 8)
Figure 15
Figure 15. Diet plan (Contd. 9)
Figure 16
Figure 16. Diet plan (Contd. 10)
Figure 17
Figure 17. Diet plan (Contd. 11)
Figure 18
Figure 18. Diet plan (Contd. 12)
Figure 19
Figure 19. Subject counselling suggestions referred to conduct this study
Figure 20
Figure 20. Subject counselling suggestions referred to conduct this study (Contd.)
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