Impact of clinical pharmacist mediated patient education on HbA1c and insulin adherence among diabetic population

Background: To evaluate the association of structured clinical pharmacist-mediated patient education with glycemic control, medication adherence, and diabetes self-management among insulin-treated adults with diabetes mellitus. Methods: A single-arm prospective cohort study was conducted from July 2024 to March 2025 among 70 adults with type 1 or type 2 diabetes mellitus receiving insulin therapy for at least three months at the Department of Diabetology, NRI Academy of Sciences General and Super Specialty Hospital, Chinakani, Andhra Pradesh, India. Participants received structured pharmacist-mediated education on diabetes self-management, insulin administration and storage, medication adherence, lifestyle modification, and self-monitoring of blood glucose, supported by a Patient Information Leaflet. HbA1c, fasting blood glucose (FBS), postprandial blood glucose (PPBS), MMAS-8, and DMSES were assessed at baseline and after three months. Continuous variables were summarized as mean ± SD and compared using paired Student’s t-tests; p<0.05 was considered statistically significant. Results: Mean HbA1c decreased from 8.754±1.915% to 8.085±1.481% (reduction 0.669%; p=0.00013). FBS decreased by 18.274 mg/dL (p=0.0078), and PPBS decreased by 25.257 mg/dL (p=0.00187). MMAS-8 increased from 3.957±1.215 to 5.585±1.210 (p=0.00000127), while DMSES increased from 4.216±1.137 to 5.983±1.408 (p=0.00000189). Conclusions: Pharmacist-mediated education was associated with improved glycemic parameters, medication adherence, and diabetes self-management self-efficacy. Due to the absence of a control group, findings represent pre-post associations rather than definitive causal effects.