Integrating motivational enhancement therapy with cognitive behavioural therapy may help people with type 1 diabetes better manage their disease. People with type 1 diabetes must inject insulin, monitor their diet, and exercise to control their blood sugar levels. Psychological issues may interfere with diabetes management and the effectiveness of psychological treatments in improving diabetes outcomes is uncertain. To investigate, researchers from UK assigned 344 type 1 diabetic patients with poorly controlled diabetes to either regular care, cognitive behavioural therapy (therapy that focuses on identifying and changing negative behaviours), or a combination of nurse-delivered cognitive behavioural therapy and motivational enhancement therapy (brief counseling that focuses on self-motivation). Over 12 months, the researchers collected information on change in blood sugar levels, low blood sugar episodes, depression, quality of life, diabetes self-care activities, and weight. It was found that patients who received both psychological therapies fared the best, having a greater decrease in blood sugar levels than patients who received usual care or motivational therapy alone. However, the changes were small and the study could not determine whether they would persist beyond 12 months.
Annals of Internal Medicine
November 2008