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Randomised controlled trial
In people with poorly controlled type 1 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months
  1. Leah Brennan
  1. Centre for Obesity Research and Education, Monash University, Victoria, Melbourne, Australia
  1. Correspondence to Leah Brennan
    Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia; leah.brennan{at}

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Commentary on: OpenUrlPubMedWeb of Science

Implications for practice

  • 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).

  • MET+CBT and MET do not result in better quality of life, depression, body mass index or diabetes self-care activities.

  • With extensive training and supervision, nurses can be trained to deliver diabetes-specific MET and CBT.

  • Cost-effectiveness was not demonstrated.

Implications for research

Further research is required to determine:

  • active components of combined MET+CBT and patient's perceptions;

  • maintenance of MET+CBT effects over time;

  • use of MET+CBT in a variety of formats (eg, group, online).


Type 1 diabetes is associated with a range of biopsychosocial consequences.1 Treatment …

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  • Competing interests None.