title: Diabetes education for children with type 1 diabetes mellitus and their families.
abstract: OBJECTIVE
  To determine the effectiveness of diabetes education on metabolic control, diabetes-related hospitalizations, complications, and knowledge, quality of life and other psychosocial outcomes for children with type 1 diabetes and their families.
  
  
  METHODS
  A systematic and comprehensive literature review was conducted in 21 electronic databases of medical and health education literature to identify randomized controlled trials (RCTs) and observational studies evaluating the effectiveness of diabetes education.
  
  
  METHODS
  Study selection, quality assessment, and data extraction were conducted independently by several investigators in duplicate. A descriptive analysis is presented.
  
  
  RESULTS
  From 12,756 citations, 80 studies were identified and included in the review (53 RCTs or CCTs, 27 observational studies). The methodological quality of studies was generally low. Most studies (35/52) that examined the effect of educational interventions on HbA1c found no evidence of increased effectiveness of the interventions over the education provided as part of standard care. Successful interventions were heterogeneous and included cognitive behavioral therapy, family therapy, skills training and general diabetes education. Most studies reported a positive effect on health service utilization (i.e., reduced use), although less than half were statistically significant. There was no clear evidence that educational interventions had an effect on short-term complications. The effect of educational interventions on diabetes knowledge was unclear with 12/30 studies reporting a significant improvement. Interventions which had varying effects on knowledge scores included diabetes camp, general diabetes education, and cognitive behavioral therapy. In the area of self management/regimen adherence, 10/21 studies reported improving this outcome significantly. Successful interventions included general diabetes education and cognitive behavioral therapy. Educational interventions were successful in improving various psychosocial outcomes. The results of two studies examining refinements to intensive therapy education suggest that educational interventions may enhance the effects of intensive diabetes management in reducing HbA1c. CONCLUSIONS Due to the heterogeneity of reported diabetes education interventions, outcome measures, and duration of followup, there is insufficient evidence to identify a particular intervention that is more effective than standard care to improve diabetes control or quality of life or to reduce short-term complications.
authors.forename: Robert
authors.initials: R
authors.lastname: Couch
authors.forename: Mary
authors.initials: M
authors.lastname: Jetha
authors.forename: Donna M
authors.initials: DM
authors.lastname: Dryden
authors.forename: Nicola
authors.initials: N
authors.lastname: Hooten
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Liang
authors.forename: Tamara
authors.initials: T
authors.lastname: Durec
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sumamo
authors.forename: Carol
authors.initials: C
authors.lastname: Spooner
authors.forename: Andrea
authors.initials: A
authors.lastname: Milne
authors.forename: Kate
authors.initials: K
authors.lastname: O'Gorman
authors.forename: Terry P
authors.initials: TP
authors.lastname: Klassen
mesh_terms: D002648:Child; D015928:Cognitive Behavioral Therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000628:therapy; D005190:Family; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D010353:Patient Education as Topic; D011788:Quality of Life; D012648:Self Care
chemical_list: D006442:Glycated Hemoglobin