We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Flexible guided self-determination intervention for younger adults with poorly controlled Type 1 diabetes, decreased HbA<sub>1c</sub> and psychosocial distress in women but not in men: a real-life RCT.
- Authors
Zoffmann, V.; Vistisen, D.; Due‐Christensen, M.
- Abstract
Aim To report results from an 18-month randomized controlled trial ( RCT) testing the effectiveness of a flexible guided self-determination ( GSD) intervention on glycaemic control and psychosocial distress in younger adults with poorly controlled Type 1 diabetes. Methods Between January 2010 and February 2012, we randomly allocated two hundred 18-35-year-olds [mean age 25.7 (5.1) years, 50% men] with Type 1 diabetes for ≥ 1 year [mean duration 13.7 (6.8) years] and HbA1c ≥ 64 mmol/mol (8.0%) to either an immediate GSD (intervention; n = 134) or 18-months delayed GSD group (control; n = 66). Group-based or individual GSD sessions were offered, drawing on reflection sheets and advanced professional communication. The primary outcome was HbA1c (measured at baseline and every three months thereafter) and among secondary outcomes was psychosocial distress (self-reported at baseline and after nine and 18 months). Intention-to-treat analyses included linear regression and repeated measurement analyses. Results A borderline significant decrease in HbA1c in the intervention group compared with the control group ( - 4 vs - 1 mmol/mol or - 0.4% vs - 0.1%; P = 0.073) was driven by a significantly greater reduction in the GSD women ( - 5 vs + 1 mmol/mol or - 0.5% vs + 0.1%; P = 0.017); parallel decreases were observed in the GSD and control men ( - 3 mmol/mol or - 0.3%; P = 0.955). Significantly greater reduction in the GSD group's psychosocial distress was again driven by differences between the GSD and the control women. The men's improvements were not connected with the intervention. Conclusions The flexible GSD intervention benefitted younger adult women by significantly improving glycaemic control and decreasing diabetes related distress. No effect was seen among men.
- Subjects
ANXIETY diagnosis; DIABETES; GLYCOSYLATED hemoglobin; MEDICAL needs assessment; TYPE 1 diabetes; METABOLIC regulation; PATIENT education; RESEARCH funding; PSYCHOLOGY
- Publication
Diabetic Medicine, 2015, Vol 32, Issue 9, p1239
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.12698