title: Short-term effects of cognitive behavioural group training (CBGT) in adult Type 1 diabetes patients in prolonged poor glycaemic control. A randomized controlled trial.
abstract: OBJECTIVE
  To assess the effects of cognitive behavioural group training (CBGT) on glycaemic control, diabetes self-efficacy and well-being in Type 1 diabetes patients in persistent poor glycaemic control.
  
  
  METHODS
  In a randomized controlled trial, a total of 107 patients with Type 1 diabetes in poor glycaemic control (HbA(1c) > or = 8%) were assigned to a 6-week CBGT or blood glucose awareness training (BGAT) as control condition. The intervention was preceded by a 3-month run-in period. Glycaemic control (HbA(1c)), diabetes-specific self-efficacy (CIDS), diabetes-related distress (PAID) and depressive symptoms (CES-D), were assessed at baseline (T1), directly before (T2) and 3 months after (T3) the intervention.
  
  
  RESULTS
  No significant changes in HbA(1c) were found after CBGT, whilst diabetes self-efficacy increased (mean CIDS score 71.6 +/- 14.0 to 74.3 +/- 12.2) and diabetes-related distress (mean PAID score 47.0 +/- 21.6 to 42.6 +/- 20.8) and depressive symptoms decreased (mean CES-D score 16.9 +/- 12.8 to 13.5 +/- 12.6). Changes in psychological outcomes were similar for both treatment groups. Diabetes self-care behaviours improved equally. Drop-out rate, which was higher among CBGT participants, was relatively low overall (total n = 15, 17.05%), and both interventions were well-appreciated by the participants.
  
  
  CONCLUSIONS
  CBGT was successful in improving self-efficacy, diabetes-related distress and mood at 3 months' follow-up, but not in improving glycaemic control.
authors.affiliation: Department of Medical Psychology, Institute for Cardiovascular Research (IcaR-VU), Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. ncw.vanderven@vumc.nl
authors.forename: N C W
authors.initials: NC
authors.lastname: van der Ven
authors.forename: M H E
authors.initials: MH
authors.lastname: Hogenelst
authors.forename: A M E
authors.initials: AM
authors.lastname: Tromp-Wever
authors.forename: J W R
authors.initials: JW
authors.lastname: Twisk
authors.forename: H M
authors.initials: HM
authors.lastname: van der Ploeg
authors.forename: R J
authors.initials: RJ
authors.lastname: Heine
authors.forename: F J
authors.initials: FJ
authors.lastname: Snoek
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000592:standards*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000592:standards; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin