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Coping skills training reduced haemoglobin A1c and improved self efficacy in youths with diabetes

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Question In adolescents with type 1 diabetes mellitus, does the addition of a behavioural programme of coping skills training (CST) to intensive diabetes management improve metabolic and psychosocial outcomes?


Randomised, double blind (clinicians and outcome assessors), controlled trial with 6 months follow up.


Yale Pediatric Diabetes Service in New Haven, Connecticut, USA.


77 adolescents who were 12.5–20 years of age (mean age 16 y, 58% girls, 92% white), had type 1 diabetes (mean duration 8.4 y) with no other health problems except for treated hypothyroidism, had been treated with insulin for ≥1 year, had haemoglobin A1c (HbA1c) concentration of 7–14%, had had no severe hypoglycaemic events in the previous 6 months, and were in an appropriate school grade for their age (within 1 year). Follow up was 100%.


Adolescents were allocated to intensive management …

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  • Sources of funding: National Institute for Nursing Research and the Yale Children's Clinical Research Center.

  • For correspondence: Dr M Grey, Yale University School of Nursing, 100 Church Street South, PO Box 9740, New Haven, CT 06536-0740, USA. Fax +1 203 737 4480.

  • Abstract and commentary also appear in Evidence-Based Mental Health.