Diabetes "coach" may help diabetic teenagers

NEW YORK (Reuters Health) - A "personal trainer" can enhance an adolescent's motivation and capability of managing diabetes, according to a randomized trial sponsored by the National Institutes of Health.

Dr. Tonja R. Nansel, at the National Institute of Child Health and Human Development in Bethesda, Maryland, and colleagues developed a program to provide young type 1, or "insulin-dependent," diabetics with one-on-one interaction with a facilitator to improve self-monitoring, goal-setting, and problem-solving.

The facilitators were called "personal trainers" to "emphasize the development of strengths rather than the amelioration of deficits," the researchers explain in a report in the medical journal Diabetes Care. The facilitators received 80 hours of training in the use of motivational interviewing, behavior analysis, and problem solving.

Eighty-one adolescents with type 1 diabetes, aged 11 to 16 years, were randomly assigned to usual care or to six sessions with a personal diabetes trainer.

Having a personal diabetes trainer appeared to have a healthy impact on blood sugar levels, the team reports. However, the between-group difference in blood sugar favoring the personal training group was significant only in the older children, aged 14 to 16 years, at the first evaluation conducted up to 9 months after the start of the study.

However, the children in the study and their parents were enthusiastic about the program, many of them wishing that the intervention had lasted longer.

"The outcomes suggest that self-management skills are a relevant and important target for improving blood (sugar) control during adolescence," Nansel's team concludes.

SOURCE: Diabetes Care, October 2007.