Motivational Interviewing and Glycemic Control in Adolescents With Poorly Controlled Type 1 Diabetes: A Randomized Controlled Pilot Trial

Autor: Anna-Kaisa Tuomaala, Matti Hero, Martti T. Tuomisto, Maria Lähteenmäki, Päivi J. Miettinen, Tiina Laine, Karoliina Wehkalampi, Sanne Kiiveri, Pekka Ahonen, Marja Ojaniemi, Kari Kaunisto, Päivi Tossavainen, Risto Lapatto, Taisto Sarkola, Mari-Anne Pulkkinen
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Frontiers in Endocrinology, Vol 12 (2021)
Druh dokumentu: article
ISSN: 1664-2392
DOI: 10.3389/fendo.2021.639507
Popis: A multicenter randomized controlled pilot trial investigated whether motivational interviewing (MI) by diabetes physicians improves glycemic control and variability in the context of follow-up for adolescent patients with poorly controlled type 1 diabetes. Patients (n = 47) aged 12 to 15.9 years who showed poor glycemic control (HbA1c >75 mmol/mol/9.0%) were randomized to standard education (SE) only or MI+SE, with study physicians randomized to employ MI+SE (N = 24 patients) or SE only (N = 23). For one year of follow-up, the main outcome measurements were obtained at three-month visits (HbA1c) or six-monthly: time in range (TIR) and glycemic variability (CV). Mean adjusted 12-month change in HbA1c was similar between the MI+SE and SE-only group (-3.6 vs. -1.0 mmol/mol), and no inter-group differences were visible in the mean adjusted 12-month change in TIR (-0.8 vs. 2.6%; P = 0.53) or CV (-0.5 vs. -6.2; P = 0.26). However, the order of entering the study correlated significantly with the 12-month change in HbA1c in the MI+SE group (r = -0.5; P = 0.006) and not in the SE-only group (r = 0.2; P = 0.4). No link was evident between MI and changes in quality of life. The authors conclude that MI’s short-term use by diabetes physicians managing adolescents with poorly controlled type 1 diabetes was not superior to SE alone; however, improved skills in applying the MI method at the outpatient clinic may produce greater benefits in glycemic control.
Databáze: Directory of Open Access Journals