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

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.