Background: Youth with poorly controlled type 1 diabetes (T1D) are at increased risk for morbidity yet very few interventions have targeted this vulnerable population. The purpose of this study was to test the feasibility, acceptability and preliminary efficacy of an intensive, team-based intervention program for youth with HbA1c ≥ 9.5%.
Methods: Forty patients (age 14.1±2.3 years, 53% male) with T1D (duration 6.5±4.3 years) were enrolled in an intensive, 4-month team-based intervention that included a visit with their primary endocrinologist and a pediatric psychologist at baseline as well as up to 6 encounters (in-person visits and calls) with a Certified Diabetes Educator (CDE). The CDE encounters were designed to establish goals, support behavior changes, review glucose logs, and make interim dose adjustments as needed. Feasibility was measured by the number of patients approached and the number of patients who ultimately agreed to participate, acceptability was measured by attendance and attrition rates, and preliminary efficacy was assessed by changes in HbA1c and diabetes-related Quality of Life (QoL). Data were collected at baseline and 4 months.
Results: Of the 42 patients who were approached, 40 agreed to participate, and 35 (87.5%) completed the 4-month program. CDE engagement with patients included an average of 3 phone calls and 3 in-person visits. Compared to baseline, HbA1c reduced from 12.0%±1.6 at baseline to 11.0%±1.9 at the 4 month visit (p<0.001) and QoL increased from 61.0±12.3 to 64.7±11.0 (P<0.05).
Conclusion: Intensive team-based interventions in pediatric patients with poorly controlled T1D can improve glycemic control and QoL.
M. Chambers: None. G.Q. Shaibi: None. C.R. Kapadia: None. F. Hoekstra: None. S.S. Puffenberger: None. L. Touger: None. I.K. Radcliffe: None. L. Holzmeister: None. K.A. Olsen: None.
Thomas J. Beatson, Jr. Foundation