Pediatric Diabetes · 2019 · 55 citations · 37 references
MedicineChronic Disease ControlHealth EducationAdolescent HealthAdolescent MedicineSelf-management SupportDiabetes ControlDiabetes ManagementDiabetes MellitusDiabetes Self-managementGlycemic ControlGlycemic MonitoringContinuous Glucose Monitoring Guided TherapyContinuous Subcutaneous InfusionContinuous Subcutaneous Insulin InfusionControl Group DesignGroup InterventionPerson-centered ModelPerson-centered TheorySelf-efficacy In Diabetes Care
INTRODUCTION: Young people with type 1 diabetes and their parents need to receive person-centered education to be able to manage their diabetes. Guided Self-Determination-Young (GSD-Y) is a person-centered communication and reflection education model that can be used in educational program for young people with type 1 diabetes. OBJECTIVE: To evaluate whether GSD-Y leads to improved glycaemic control, increased self-perceived health and health-related quality of life, fewer diabetes-related family conflicts, and improved self-efficacy in a group-based intervention for adolescents starting continuous subcutaneous insulin infusion (CSII) and their parents. METHODS: This randomized controlled trial included 71 adolescents starting CSII. Participants were followed for 12 months. The intervention group (n = 37) attended seven group training sessions over a period of 5 months, using the GSD-Y model, the control group received standard care. Variables evaluated were HbA1c, self-perceived health, health-related quality of life, family conflicts, self-efficacy, and usage of continuous glucose monitoring. RESULTS: When adjusted for sex and family conflicts, there was a difference in glycaemic control between the groups at 12 months, favoring the intervention group (62 vs 70 mmol/mol, P = .009). When analyses were performed on boys and girls separately and adjusted for family conflicts, the only difference detected was for boys after 12 months (P = .019). The intervention showed no effect on self-perceived health, health-related related quality of life, family conflicts, or self-efficacy. CONCLUSIONS: An intervention with GSD-Y may have an effect on glycaemic control. The content of the GSD-Y groups may serve as a model for person-centered care in adolescents with type 1 diabetes.
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