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?
Design
Randomised (unclear allocation concealment), blinded (clinicians and outcome assessors), controlled trial with 12 months of follow up.
Setting
A diabetes clinic in New Haven, Connecticut, USA.
Patients
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).
Intervention
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 …
