title: A cognitive behavior therapy-based intervention among poorly controlled adult type 1 diabetes patients--a randomized controlled trial.
abstract: OBJECTIVE
  To examine the impact of a Cognitive Behavior Therapy (CBT)-based intervention on HbA(1c), self-care behaviors and psychosocial factors among poorly controlled adult type 1 diabetes patients.
  
  
  METHODS
  Ninety-four type 1 diabetes patients were randomly assigned to either an intervention group or a control group. The intervention was based on CBT and was mainly delivered in group format, but individual sessions were also included. All subjects were provided with a continuous glucose monitoring system (CGMS) during two 3-day periods. HbA(1c), self-care behaviors and psychosocial factors were measured up to 48 weeks.
  
  
  RESULTS
  Significant differences were observed with respect to HbA(1c) (P<0.05), well-being (P<0.05), diabetes-related distress (P<0.01), frequency of blood glucose testing (P<0.05), avoidance of hypoglycemia (P<0.01), perceived stress (P<0.05), anxiety (P<0.05) and depression (P<0.05), all of which showed greater improvement in the intervention group compared with the control group. A significant difference (P<0.05) was registered with respect to non-severe hypoglycemia, which yielded a higher score in the intervention group.
  
  
  CONCLUSIONS
  This CBT-based intervention appears to be a promising approach to diabetes self-management.
  
  
  CONCLUSIONS
  Diabetes care may benefit from applying tools commonly used in CBT. For further scientific evaluation in clinical practice, there is a need for specially educated diabetes care teams, trained in the current approach, as well as cooperation between diabetes care teams and psychologists trained in CBT.
authors.affiliation: Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Medicine, Stockholm, Sweden. susanne.amsberg@ki.se
authors.forename: Susanne
authors.initials: S
authors.lastname: Amsberg
authors.forename: Therese
authors.initials: T
authors.lastname: Anderbro
authors.forename: Regina
authors.initials: R
authors.lastname: Wredling
authors.forename: Jan
authors.initials: J
authors.lastname: Lisspers
authors.forename: Per-Eric
authors.initials: PE
authors.lastname: Lins
authors.forename: Ulf
authors.initials: U
authors.lastname: Adamson
authors.forename: Unn-Britt
authors.initials: UB
authors.lastname: Johansson
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015190:Blood Glucose Self-Monitoring; D015928:Cognitive Behavioral Therapy; D016001:Confidence Intervals; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care
chemical_list: D006442:Glycated Hemoglobin