Effects of educational and psychosocial interventions for adolescents with diabetes mellitus: a systematic review

Abstract

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A Multicenter Randomized Controlled Trial of Motivational Interviewing in Teenagers With Diabetes

“…It extends the evidence and confirms the beneficial impact of psychosocial interventions based on the principles of motivational interviewing that have been previously reported in smaller-scale stud- ies (8,9). Furthermore, this study is one of very few that demonstrate, using a randomized control study design, the potential of a psychosocial intervention to improve glycemic control in children with diabetes over a time period as long as two years (4). Given the potential benefit of improved glycemic control on the future risks of developing microvascular complications of diabetes (3), our results suggest that psychosocial interventions such as motivational interviewing may be of value in addition to pharmacological developments in reducing the longerterm adverse consequences of diabetes.…”

A randomised controlled trial of cognitive behaviour therapy and motivational interviewing for people with Type 1 diabetes mellitus with persistent sub-optimal glycaemic control: A Diabetes and Psychological Therapies (ADaPT) study.

“…One review included only children and adolescents with type 1 diabetes as the population of interest and did not distinguish between psychological and educational interventions. 82 They found a standardised pooled effect size of 0.33 and they interpreted this as small to medium. Another review did not distinguish between type 1 or type 2 diabetes which does not seem appropriate as the epidemiology, natural history, sociodemographic profile and treatments are different.…”

Poor Prognosis of Young Adults With Type 1 Diabetes

“…However, because psychiatric outcomes were predicted by psychiatric symptoms in late adolescence and young adulthood, much earlier identification and treatment of at-risk patients is probably needed. Intensive educational and behavioral treatments seem to have limited efficacy (26), and individualized therapy using cognitive behavioral principles dealing with specific misconceptions and inappropriate beliefs about diabetes and its treatment may be more effective in changing attitudes and behavior (27,28). In summary, without early identification and treatment of at-risk patients, our results suggest that psychiatric disorders, subthreshold psychological distress, and behavioral problems may persist well into adulthood and predict later psychiatric symptoms in many patients with childhood and adolescentonset type 1 diabetes.…”