Patient empowerment and glycemic control among adults with type 2 diabetes in Madinah, Saudi Arabia

Type 2 diabetes mellitus (T2DM) is a significant public health challenge in Saudi Arabia. While glycemic control (HbA1c) is a key management goal, psychosocial factors like patient empowerment are understudied in this context. This study aimed to investigate the relationship between patient empowerment and glycemic control among adults with T2DM in Madinah. This cross-sectional analytical study was conducted between February and June 2025 in 3 primary healthcare centers and 1 specialized diabetes hospital in Madinah. A total of 300 adults with T2DM were recruited via convenience sampling, where researchers approached eligible patients in clinic waiting areas. Data were collected using a structured questionnaire and electronic medical records. Patient empowerment was measured using the Diabetes Empowerment Scale-Short Form (DES-SF). Glycemic control was the primary outcome (most recent HbA1c). Statistical analysis included descriptive statistics, nonparametric tests (Mann-Whitney U, Kruskal-Wallis), Spearman's correlation, and multivariate linear regression to identify independent predictors of HbA1c. The mean HbA1c level was 7.99% ± 1.95, and the mean DES-SF score was 3.64 ± 0.34. The final regression model was statistically significant (P = .001). After adjusting for confounders, higher patient empowerment was a significant predictor of lower HbA1c (B = -0.792, P = .015). Older age (B = -0.018, P = .034) and being an ex-smoker (B = -0.712, P = .018) were also associated with lower HbA1c levels. This study provides evidence that higher patient empowerment is independently associated with better glycemic control in a Saudi population. These findings underscore the clinical importance of integrating empowerment-based strategies into standard diabetes care to improve patient outcomes. Routine use of the DES-SF can help clinicians and the Ministry of Health identify patients with low empowerment who would benefit from targeted support. This research provides one of the few context-specific studies in the Middle East to explicitly link patient empowerment (quantified using the validated DES-SF) with objective glycemic outcomes (HbA1c) in a Saudi population. The study's rigor is enhanced by its relatively large, multi-clinic sample (N = 300) and the use of multivariate regression to adjust for key confounders.