A person-centered education for adolescents with type 1 diabetes-A randomized controlled trial

Pediatr Diabetes. 2019 Nov;20(7):986-996. doi: 10.1111/pedi.12888. Epub 2019 Jul 18.

Abstract

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.

Keywords: adolescent; diabetes mellitus; health education; parents; type 1.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Glucose / analysis
  • Blood Glucose / drug effects
  • Blood Glucose Self-Monitoring
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / psychology
  • Diabetes Mellitus, Type 1 / therapy*
  • Family Conflict
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Insulin / administration & dosage
  • Insulin Infusion Systems
  • Male
  • Parent-Child Relations
  • Parents
  • Patient Education as Topic / methods*
  • Patient-Centered Care / methods*
  • Perception
  • Precision Medicine / methods*
  • Quality of Life
  • Self Care* / methods
  • Self Care* / psychology
  • Self Efficacy
  • Self-Management / education*
  • Self-Management / psychology
  • Sweden

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Insulin