title: A novel behavioral intervention in adolescents with type 1 diabetes mellitus improves glycemic control: preliminary results from a pilot randomized control trial.
abstract: The purpose of this study was to develop and pilot-test an innovative behavioral intervention in adolescents with type 1 diabetes mellitus (T1DM) incorporating structured care of a pet to improve glycemic control.
  
  
  
  Twenty-eight adolescents with A1C > 8.5% (69 mmol/mol) were randomly assigned to either the intervention group (care of a Betta splendens pet fish) or the control group (usual care). Adolescents in the intervention group were given instructions to associate daily and weekly fish care duties with diabetes self-management tasks, including blood glucose testing and parent-adolescent communication.
  
  
  
  After 3 months, the participants in the intervention group exhibited a statistically significant decrease in A1C level (-0.5%) compared with their peers in the control group, who had an increase in A1C level (0.8%) (P = .04). The younger adolescents (10-13 years of age) demonstrated a greater response to the intervention, which was statistically significant (-1.5% vs 0.6%, P = .04), compared with the older adolescents (14-17 years of age).
  
  
  
  Structured care of a pet fish can improve glycemic control in adolescents with T1DM, likely by providing cues to perform diabetes self-management behaviors.
authors.affiliation: Department of Quantitative Health Science, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Maranda)
authors.forename: Louise
authors.initials: L
authors.lastname: Maranda
authors.affiliation: Division of General Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas (Dr Lau)
authors.forename: May
authors.initials: M
authors.lastname: Lau
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas (Dr Stewart)
authors.forename: Sunita M
authors.initials: SM
authors.lastname: Stewart
authors.affiliation: Division of Endocrinology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas (Dr Gupta)
authors.forename: Olga T
authors.initials: OT
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000818:Animals; D001521:Behavior Therapy / Q000379:methods*; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring / Q000523:psychology*; D002648:Child; D003142:Communication; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D005260:Female; D005399:Fishes; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D057805:Pets / Q000523:psychology*; D010865:Pilot Projects; D012648:Self Care / Q000523:psychology*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human