Background The aim of the study was to investigate whether simulation education (SE) and case management had any effect on glycemic control in type 2 diabetes (T2DM) patients. Methods In this single center pilot trial, 100 T2DM patients who received medication and basic diabetes self‐management education (DSME) were randomly divided into a control group ( n = 50) and an experimental group ( n = 50), who received SE and a case management program. Evaluation of biochemical indices was conducted at baseline and after 6 months. DSME consisted of 2‐hour group trainings weekly for 2 consecutive weeks followed by 2 × 30 minute education sessions after 3 and 6 months. The SE program comprised additional 50‐minute video sessions 3 times in the first week and twice in the second week. The experimental group was supervised by a nurse case manager, who followed up participants at least once a month, and who conducted group sessions once every 3 months, focusing on realistic aspects of physical activity and nutrition, with open discussions about setting goals and strategies to overcome barriers. Results After 6 months, HbA1c, fasting plasma glucose, and postprandial blood glucose level improvements were superior in the experimental group compared with the control group ( P < 0.05). Self‐care behavior adherence scores of healthy diet ( P = 0.001), physical activity ( P = 0.043), self‐monitoring of blood glucose ( P < 0.001), and reducing risks ( P < 0.001) were significantly increased in the experimental group compared with the control group. Conclusions Simulation education and case management added to routine DSME effectively improved glycemic control in T2DM patients.