In people with poorly controlled type 1 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months
- Centre for Obesity Research and Education, Monash University, Victoria, Melbourne, Australia
- Correspondence to Leah Brennan
Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia; leah.brennan{at}monash.edu
Implications for practice
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▪ Motivational enhancement therapy (MET) +cognitive–behavioural therapy (CBT) can improve 12-month glycaemic control in adults with poorly controlled type 1 diabetes and is more effective than MET alone or usual care (UC).
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▪ MET+CBT and MET do not result in better quality of life, depression, body mass index or diabetes self-care activities.
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▪ With extensive training and supervision, nurses can be trained to deliver diabetes-specific MET and CBT.
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▪ Cost-effectiveness was not demonstrated.
Implications for research
Further research is required to determine:
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▪ active components of combined MET+CBT and patient's perceptions;
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▪ maintenance of MET+CBT effects over time;
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▪ use of MET+CBT in a variety of formats (eg, group, online).
Context
Type 1 diabetes is associated with a range of biopsychosocial consequences.1 Treatment targets self-care (eg, diet, exercise, medication) aimed at optimising glycaemic control thus minimising the risk of medical/health complications. However, between quarter and half of all adults with type 1 diabetes have suboptimal glycaemic control.1
Maintaining behaviour changes in the absence of immediate consequences …
