This study shows that treatment with CSII resulted in an improvement in HbA1c levels up to 1 yr and decreased the number of severe hypoglycaemic events, but the frequency of ketoacidosis increased. The major challenge is to identify methods to maintain the HbA1c improvement, especially among older children and teenagers, and reduce the frequency of ketoacidosis.
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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