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Effects of peer-group intervention on metabolic control of adolescents with IDDM. Randomized outpatient study.

Abstract
In children with insulin-dependent diabetes mellitus (IDDM), deterioration in metabolic control frequently occurs during early adolescence. To prevent this predictable increase in blood glucose levels, we randomly assigned young adolescents with IDDM to an intervention based on problem solving with self-monitoring of blood glucose (SMBG) integrated into standard outpatient care or to standard care only for an 18-mo period. At follow-up, 50% of the standard-care adolescents exhibited greater than 1% increase in glycosylated hemoglobin (HbA1) levels over baseline values, indicating a deterioration in metabolic control, compared to only 23% of the intervention group. Follow-up HbA1 means +/- SD were 10.10 +/- 2.00% for intervention and 11.04 +/- 2.28% for standard-care adolescents, indicating a significantly lower value in the intervention group (P = .04). At follow-up, a greater percentage of intervention than standard-care adolescents reported using SMBG information when they exercised (60.0 vs. 33.3%, chi 2 = 4.29, P = .04). Our data suggest that clinic-based problem-solving groups can be more effective with young adolescents with IDDM than conventional treatment in preventing the expected deterioration in blood glucose.
AuthorsB J Anderson, F M Wolf, M T Burkhart, R G Cornell, G E Bacon
JournalDiabetes care (Diabetes Care) Vol. 12 Issue 3 Pg. 179-83 (Mar 1989) ISSN: 0149-5992 [Print] United States
PMID2649330 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Glycated Hemoglobin A
Topics
  • Adolescent
  • Blood Glucose Self-Monitoring
  • Clinical Trials as Topic
  • Diabetes Mellitus, Type 1 (blood, psychology, rehabilitation)
  • Exercise
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin (analysis)
  • Humans
  • Male
  • Patient Education as Topic
  • Problem Solving
  • Random Allocation
  • Socioeconomic Factors

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