Background &amp; objective <p>Type 2 Diabetes (T2D) is a chronic metabolic disorder characterized by impaired insulin secretion, insulin resistance, and progressive β-cell dysfunction that ultimately leads to serious vascular and metabolic complications. Effective diabetes management requires innovative approaches such as remote education and nurse-led interventions. Therefore, this study aimed to investigate the effect of remote nurse-led patient education and follow-up on glycemic control and key metabolic functions including pancreatic β-cell function (HOMA-β), insulin sensitivity (HOMA-α), and insulin resistance (HOMA-IR) in T2D patients.</p> Methods &amp; materials <p>This is a single-blind randomized controlled trial conducted on a total of 66 patients with T2D. Participants were randomly assigned to the intervention (<i>n</i> = 33) and control (<i>n</i> = 33) groups. The intervention group received three months of daily remote education via text, audio, and video messages combined with weekly follow-ups. Baseline and post-intervention data included Fasting Blood Glucose (FBG), fasting insulin, glycosylated hemoglobin (HbA1c), and HOMA indices. Data were analyzed using IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, N.Y., USA).</p> Results <p>Significant within-group improvements were observed in the intervention group for FBG, HbA1c, HOMA-β, HOMA-α, and HOMA-IR scores (<i>p</i> &lt; 0.05); however, the control group showed no significant within-group changes (<i>p</i> &gt; 0.05). Between-group analysis showed greater improvements in the intervention group compared to the control group for all above outcomes (<i>p</i> &lt; 0.05).</p> Conclusion <p>In this randomized trial, a three-month remote nurse-led patient education and follow-up program was associated with improvements in several glycemic and metabolic markers, including FBG, HbA1c, HOMA-IR, HOMA-α, and HOMA-β, compared with usual care. These preliminary findings suggest potential metabolic benefits and highlight the need for larger, longer-term studies to confirm these effects before broader clinical application.</p> Trial registration <p>This study was prospectively registered in the Iranian Registry of Clinical Trials on 15 July 2024 (<i>IRCT20240708062366N1</i>, <a href="https://irct.behdasht.gov.ir/trial/77809">https://irct.behdasht.gov.ir/trial/77809</a>). After trial registration, participant recruitment began on 1 August 2024 and continued until 1 October 2024.</p>