A Behavioral Medicine Intervention among Poorly Controlled Adult Type 1 Diabetes Patients - a Randomized Controlled Trial
Abstract Number: 113-OR
Authors: SUSANNE AMSBERG, THERESE ANDERBRO, REGINA WREDLING, JAN LISSPERS, PER-ERIC LINS, ULF ADAMSON, UNN-BRITT JOHANSSON, Stockholm, Sweden, Östersund, Sweden
Institutions: Östersund, Sweden ; Stockholm, Sweden
Results: A recent meta-analysis found evidence for the effectiveness of psychological treatments in improving glycemic control in children and adolescents but not in adults with type 1 diabetes. In the present study we investigated the effects of a behavioral medicine intervention supported by a maintenance program on HbA1c and self-care behaviors among poorly controlled adult type 1 diabetes patients up to 12 months. 94 patients who met inclusion criteria, diabetes for at least two years, age 18-65 years, HbA1c > 7.5% and BMI < 30 kg/m2 were randomly assigned either to an intervention group or a control group. Patients in the intervention group participated in a behavioral medicine intervention with the aim of improving self-care and metabolic control. The program was mainly delivered in a group format, but individual sessions were also included. A basic program of eight sessions with the purpose to map behaviors and to teach tools suitable for behavior change was given over eight weeks. In a subsequent structured maintenance program with focus on maintaining behavior changes participants were followed up to 12 months. At the end of the study, significant differences were observed with respect to HbA1c (P<0.05), well-being (P<0.01), diabetes-related distress (P<0.01), frequency of blood glucose testing (P<0.05), fear of hypoglycemia (P<0.05), perceived stress (P<0.05) and depression (P<0.05), all of which improving more in the intervention group compared with the control group. We conclude that this behavioral medicine intervention seems to offer a promising approach to poorly controlled adult patients with type 1 diabetes worthy of further evaluation in clinical practice.