Adolescents with poorly controlled diabetes do better with a programme of intensive, home-based, family-centered psychotherapy. Teens with type 1 diabetes, which requires regular insulin injections and careful monitoring of blood sugar levels, have been considered very difficult to manage clinically. Researchers from the Wayne State University in Detroit randomly assigned 127 adolescents with a history of poorly controlled type 1 diabetes to standard medical care only or to standard medical care plus 6 months of an intervention targeting problems related to adherence to diabetes treatment. The behavioural intervention was successful in improving diabetes control. Average long-term blood sugar control improved to a degree that was both statistically significant and clinically meaningful. The study showed that families were willing to receive behavioural treatment when it was provided in their home and that such intensive behavioural interventions resulted in improved outcomes. The strategy led to more frequent blood glucose testing. Frequent testing of blood glucose has been linked to better metabolic control and may therefore account for the improvements in metabolic control experienced by the group, according to the researchers. The study shows that home-based therapy holds promise in improving the diabetes management and metabolic control of adolescents but longer follow up is needed to see whether the effects are long-lasting.
Diabetes Care,
July 2005