Aims This study aimed to investigate the effectiveness and understand the process of a nurse‐led social media intervention for health behavior and glucose control for diabetes self‐management among patients with type 2 diabetes mellitus. Design This study had an explanatory sequential mixed methods design, with a randomized controlled trial and qualitative interviews. Methods A total of 89 patients diagnosed with type 2 diabetes mellitus were randomly assigned to an intervention or a control group. Patients in the intervention group were invited to join the closed nurse‐led social media platform that included diabetes information, action planning, unmoderated chat, and questions and answers. The outcomes of diabetes self‐care behavior, hemoglobin A1c (HbA1c) percentage, fasting blood sugar level (FBS), systolic and diastolic blood pressure, and triglyceride (TG) and total cholesterol levels were measured at baseline, 3 months, and 6 months. A linear mixed model was used to analyze the effectiveness of the intervention over time. Qualitative data were collected from interviews with seven patients engaged in the intervention and analyzed using qualitative content analysis. Findings After 6 months, insulin users who were provided with the social media intervention had significantly lower FBS and TG levels than those with usual care (135.80 ± 12.37 vs. 175.82 ± 15.34 mg/dL, p = 0.049; 206.85 ± 38.26 vs. 387.50 ± 56.19 mg/dL, p = 0.013; respectively). Although a similar rate of decrease in the HbA1c level over time was observed among insulin and noninsulin users after the social media intervention, this decrease was significantly greater among noninsulin users at 3 and 6 months compared with the control group (6.38 ± 0.34 vs. 7.25 ± 0.24, p = 0.040; 6.31 ± 0.37 vs. 7.28 ± 0.26, p = 0.036; respectively). Interview with seven patients who engaged in the intervention revealed that their engagement in the intervention was primarily determined by their acceptance of the role of managing their diabetes. Being engaged in the intervention, patients benefited from information sharing and interactive support to motivate their self‐care, nurses' professional advice to modify their behaviors, and action planning to make progress toward behavioral change. Conclusions The positive outcomes of the nurse‐led social media intervention indicate that the social media platform is an effective strategy to implement diabetes self‐management in clinical nursing practice. Clinical Relevance The social media intervention would be successfully implemented by nurses to facilitate patients accepting their role in diabetes management and employing key services for diabetes information, support, professional advice, and action planning.

The purpose of the study was to evaluate the influence of patient activation on diabetes self-care activities and diabetes-specific distress among patients with type 2 diabetes mellitus. Methods: This cross-sectional correlational study was a secondary data analysis, utilizing data collected from September 2016 to July 2017, for 151 adults diagnosed with type 2 diabetes in ambulatory endocrinology units of two tertiary hospitals in a metropolitan city. The instruments used for data collection included the Summary of Diabetes Self-Care Activities Questionnaire, the Patient Activation Scale, and the Brief Diabetes Distress Screening Instrument. Hierarchical multiple linear regression analyses were conducted to test the influence of patient activation levels on self-care activities and diabetes-specific distress, after controlling for demographic and clinical variables. Results: The average patient activation level was 67.8±16.72 (with the possible range from 0 to 100), and the average diabetes-specific distress level was 6.91±2.69 (with the possible range from 2 to 12). Diabetes self-care activities scores were highest in medication adherence and lowest in glucose self-monitoring. Patient activation was the significant factor influencing self-care activities, after controlling for demographic and clinical variables, but showed no significant influence on diabetes-specific distress. Oral hypoglycemic agents and insulin medications were the significant factors influencing diabetes-specific distress. Conclusion: These findings indicate the importance of nursing interventions to improve patient activation and to alleviate diabetes-specific distress. Therefore, in order to improve diabetes self-care activities, it is necessary to facilitate patient activation for diabetes care.