Katie Weinger|Elizabeth A. Beverly|Yishan Lee|Lilya Sitnokov|Om P Ganda|A. Enrique Caballero
The Effect of a Structured Behavioral Intervention on Poorly Controlled Diabetes
Joslin Diabetes Center
h3backgroundh3although maintaining nearly normal glycemia delays onset slows progression diabetes complications many patients diabetes physicians struggle achieve glycemic targets best methods support patients follow diabetes prescriptions recommendations unclearh3methodsh3to test efficacy behavioral diabetes intervention improving glycemia longduration poorly controlled diabetes randomized 222 adults diabetes 49 type 1 mean sd age 53 12 years mean sd disease duration 18 12 years mean sd hemoglobin asub1csub hbasub1csub concentration 90 11 attend 1 5session manualbased educatorled structured group intervention cognitive behavioral strategies structured behavioral arm 2 educatorled attention control group education program group attention control 3 unlimited individual nurse dietitian education sessions 6 months individual control outcomes baseline 3 6 12month postintervention hbasub1csub levels primary frequency diabetes selfcare 3day pedometer readings 24hour diet recalls average number glucose checks physical fitness depression coping style selfefficacy quality life secondaryh3resultsh3linear mixed modeling found groups showed improved hbasub1csub levels p lt 001 however structured behavioral arm showed greater improvements group individual control arms 3month hbasub1csub concentration changes 08 vs 04 04 respectively p 04 group time interaction furthermore participants type 2 disease showed greater improvement type 1 p 04 type diabetes time interaction quality life glucose monitoring frequency diabetes selfcare differ intervention timeh3conclusionsh3a structured cognitive behavioral program effective 2 control interventions improving glycemia adults longduration diabetes educators successfully use modified psychological behavioral strategiesh3trial registrationh3clinicaltrialsgov identifier nct000142922