A cognitive behavior therapy-based intervention among poorly controlled adult type 1 diabetes patients--a randomized controlled trial.
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.
Amsberg
Susanne
S
Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Medicine, Stockholm, Sweden. susanne.amsberg@ki.se
Anderbro
Therese
T
Wredling
Regina
R
Lisspers
Jan
J
Lins
Per-Eric
PE
Adamson
Ulf
U
Johansson
Unn-Britt
UB
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
D006442:Glycated Hemoglobin