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 …