Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2010 Jul;33(7):1658-64.
doi: 10.2337/dc09-2268.

Interventions with adherence-promoting components in pediatric type 1 diabetes: meta-analysis of their impact on glycemic control

Korey K Hood  1 , Jennifer M Rohan, Claire M Peterson, Dennis Drotar
Affiliations
Meta-Analysis

Interventions with adherence-promoting components in pediatric type 1 diabetes: meta-analysis of their impact on glycemic control

Korey K Hood et al. Diabetes Care. 2010 Jul.

Abstract

Objective: To review interventions with adherence-promoting components and document their impact on glycemic control via meta-analysis.

Research design and methods: Data from 15 studies that met the following criteria were subjected to meta-analysis: 1) randomized, controlled trial, 2) study sample included youth aged <19 years, 3) youth had type 1 diabetes, 4) study reported results on glycemic control; and 5) study reported use of adherence- or self-management-promoting components.

Results: The 15 studies included 997 youth with type 1 diabetes. The mean effect size for pre- to posttreatment change for the intervention versus control group comparison was 0.11 (95% CI -0.01 to 0.23). This is a small effect, demonstrating very modest improvements in glycemic control. However, analysis for the pre- to posttreatment effects for the intervention group alone did show significant variability [Q(14) = 33.11; P < 0.05]. Multicomponent interventions, those that targeted emotional, social, or family processes that facilitate diabetes management, were more potent than interventions just targeting a direct, behavioral process (e.g., increase in blood glucose monitoring frequency).

Conclusions: Interventions that focus on direct, behavioral processes and neglect emotional, social, and family processes are unlikely to have an impact on glycemic control; multicomponent interventions showed more robust effects on A1C. Future clinical research should focus on refining interventions and gathering more efficacy and effectiveness data on health outcomes of the pediatric patients treated with these interventions.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Effect sizes and confidence intervals for the individual studies.
See this image and copyright information in PMC

References

    1. Hood KK, Peterson CM, Rohan JM, Drotar D: Association between adherence and glycemic control in pediatric type 1 diabetes: a meta-analysis. Pediatrics 2009; 124: e1171–e1179 - PubMed
    1. Johnson SB, Kelly M, Henretta JC, Cunningham WR, Tomer A, Silverstein JH: A longitudinal analysis of adherence and health status in childhood diabetes. J Pediatr Psychol 1992; 17: 537–553 - PubMed
    1. Silverstein JH, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, Deeb L, Grey M, Anderson B, Holzmeister LA, Clark N: Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005; 28: 186–212 - PubMed
    1. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group. J Pediatr 1994; 125: 177–188 - PubMed
    1. White NH, Cleary PA, Dahms W, Goldstein D, Malone J, Tamborlane WV: Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA 2002; 287: 2563–2569 - PMC - PubMed

Publication types