Effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control among Type-2 Diabetes patients in northern Nigeria (SLIC-T2D trial): A Randomised Controlled Trial

BACKGROUND Optimal glycaemic control is crucial in diabetic care as it minimizes complications. Adherence to a healthy lifestyle positively impacts diabetic care. This study aimed to investigate the effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control. METHODS The study was a randomised controlled trial (RCT) conducted among Type-2 Diabetes Mellitus (T2DM) patients over 22 weeks from November 2023 to April 2024. Participants were randomly assigned to either intervention or control arms by block randomization in blocks of four using a table of random numbers at a 1:1 ratio, with 63 participants in each arm. Data were collected using an adapted WHO STEPS questionnaire on sociodemographic, clinical characteristics and lifestyle practices both pre- and post-intervention. A composite Health Behaviour Score (HBS) was used for scoring. Structured counselling was conducted using the 5A’s framework, with five follow-up telephone reminders containing standard pre-recorded messages in Hausa (predominant language) and English. RESULTS The study found a significant post‑intervention increase in healthy behaviour scores; intervention (73.8%) compared to control (26.2%). The difference was statistically significant (χ² = 29.3, p < 0.001), while both arms had pre-intervention comparable baseline healthy behaviour scores (χ² = 0.145, p = 0.703). The Wilcoxon signed-rank test indicated a statistically significant decrease in median HbA1c post-intervention in both arms (intervention: z = -3.774, p < 0.001; control: z = -3.158, p = 0.002). However, the effect of counselling on glycaemic control was not statistically significant (𝛘 ²  = 3.517 p = 0.061). CONCLUSION Structured lifestyle modification counselling significantly improved healthy behaviour among T2DM patients with no significant effect on glycaemic control. This suggests that counselling is effective for lifestyle change. Therefore, integrating structured lifestyle counselling with telephone reminders may serve as an innovative way to promote healthy lifestyles in the busy resource-limited primary care setting. TRIAL REGISTRATION The trial was registered by Pan African Clinical Trial Registry (https//pactr.samrc.ac.za) with registration number PACTR202601577207835 registered on 20th January, 2026.