Evid Based Nurs 4:11 doi:10.1136/ebn.4.1.11
  • Treatment

Intensive diabetes management plus coping skills training improved metabolic control and quality of life in adolescents

 QUESTION: Is a behavioural programme of intensive diabetes management (IDM) plus coping skills training (CST) more effective than IDM alone for improving metabolic and psychosocial outcomes in adolescents with type 1 diabetes mellitus?


Randomised (unclear allocation concealment), blinded (clinicians and outcome assessors), controlled trial with 12 months of follow up.


A diabetes clinic in New Haven, Connecticut, USA.


77 patients who were 12–20 years of age, had no other health problems except for treated hypothyroidism, had been treated with insulin for ≥1 year, had a recent glycated haemoglobin concentration (HbA1c) of 7% to 14%, had no severe hypoglycaemic events in the previous 6 months, and were in a school grade appropriate to age within 1 year. Follow up was 97% (mean age 14 y, 57% girls, 92% white).


42 participants were allocated to IDM plus CST and 35 were allocated to IDM alone. IDM comprised ≥3 daily insulin injections or continuous subcutaneous insulin infusion, self monitoring of blood glucose concentrations ≥4 times …

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