Coping skills training reduced haemoglobin A1c and improved self efficacy in youths with diabetes
Question In adolescents with type 1 diabetes mellitus, does the addition of a behavioural programme of coping skills training (CST) to intensive diabetes management improve metabolic and psychosocial outcomes?
Design
Randomised, double blind (clinicians and outcome assessors), controlled trial with 6 months follow up.
Setting
Yale Pediatric Diabetes Service in New Haven, Connecticut, USA.
Patients
77 adolescents who were 12.5–20 years of age (mean age 16 y, 58% girls, 92% white), had type 1 diabetes (mean duration 8.4 y) with no other health problems except for treated hypothyroidism, had been treated with insulin for ≥1 year, had haemoglobin A1c (HbA1c) concentration of 7–14%, had had no severe hypoglycaemic events in the previous 6 months, and were in an appropriate school grade for their age (within 1 year). Follow up was 100%.
Intervention
Adolescents were allocated to intensive management plus CST (n=42) or intensive management alone (n=35). Intensive management consisted of ≥3 daily insulin injections or an external insulin pump, …
