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
Randomized Controlled Trial
. 2013 Sep;36(9):2475-82.
doi: 10.2337/dc12-2199. Epub 2013 Apr 11.

Internet psycho-education programs improve outcomes in youth with type 1 diabetes

Margaret Grey  1 , Robin Whittemore, Sangchoon Jeon, Kathryn Murphy, Melissa S Faulkner, Alan Delamater; TeenCope Study Group
Collaborators, Affiliations
Randomized Controlled Trial

Internet psycho-education programs improve outcomes in youth with type 1 diabetes

Margaret Grey et al. Diabetes Care. 2013 Sep.

Abstract

Objective: The purpose of this study was to determine the efficacy of two Internet-based psycho-educational programs designed to improve outcomes for youth with type 1 diabetes transitioning to adolescence.

Research design and methods: The study was a multisite clinical trial of 320 youth (aged 11-14 years; 37% minority; 55% female) randomized to one of two Internet-based interventions: TeenCope or Managing Diabetes. Primary outcomes were HbA1c and quality of life (QOL). Secondary outcomes included coping, self-efficacy, social competence, self-management, and family conflict. Data were collected at baseline and after 3, 6, and 12 months online. Youth were invited to cross over to the other program after 12 months, and follow-up data were collected at 18 months. Analyses were based on mixed models using intent-to-treat and per-protocol procedures.

Results: Youth in both groups had stable QOL and minimal increases in HbA1c levels over 12 months, but there were no significant differences between the groups in primary outcomes. After 18 months, youth who completed both programs had lower HbA1c (P = 0.04); higher QOL (P = 0.02), social acceptance (P = 0.01), and self-efficacy (P = 0.03) and lower perceived stress (P = 0.02) and diabetes family conflict (P = 0.02) compared with those who completed only one program.

Conclusions: Internet interventions for youth with type 1 diabetes transitioning to adolescence result in improved outcomes, but completion of both programs was better than only one, suggesting that these youth need both diabetes management education and behavioral interventions. Delivering these programs via the Internet represents an efficient way to reach youth and improve outcomes.

Trial registration: ClinicalTrials.gov NCT00684658.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT flow diagram. x-over, crossover.
See this image and copyright information in PMC

References

    1. Amiel SA, Caprio S, Sherwin RS, Plewe G, Haymond MW, Tamborlane WV. Insulin resistence of puberty: A defect restricted to peripheral glucose metabolism. J Clin Endocrinol Metab 1991;72:277–282 - PubMed
    1. Insabella G, Grey M, Knafl GK, Tamborlane WV. Transition from adolescence to young adulthood in youth with T1D. Pediatr Diabetes 2007;8:228–234 - PubMed
    1. Karlsson A, Arman M, Wikblad K. Teenagers with type 1 diabetes—a phenomenological study of the transition towards autonomy in self-management. Int J Nurs Stud 2008;45:562–570 - PubMed
    1. Schilling LS, Knafl KA, Grey M. Changing patterns of self-management in youth with type I diabetes. J Pediatr Nurs 2006;21:412–424 - PubMed
    1. Amiel SA, Sherwin RS, Simonson DC, Lauritano AA, Tamborlane WV. Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes. N Engl J Med 1986;315:215–219 - PubMed

Publication types

Substances

Associated data