(HealthDay)—Both education/behavioral and emotion-focused approaches can effectively reduce diabetes distress (DD) among patients with type 1 diabetes (T1D) and elevated hemoglobin A1c (HbA1c), according to a study published online July 5 in Diabetes Care.
Lawrence Fisher, Ph.D., from the University of California, San Francisco, and colleagues compared the effectiveness of two interventions—OnTrack, an emotion-focused intervention, or KnowIt, an educational/behavioral intervention—to reduce DD and improve glycemic control among 301 adults with T1D.
The researchers found that both groups demonstrated dramatic reductions in DD, with 78.4 percent demonstrating a reduction of at least one minimal clinically important difference. However, there were no significant differences in DD reduction between the two programs. According to moderator analyses, OnTrack provided greater DD reduction to participants with initially poorer cognitive or emotion regulation skills, higher baseline DD, or greater initial diabetes knowledge, compared to KnowIt. Similar significant, but modest, reductions in HbA1c occurred in both groups. Also in both groups, change in DD was modestly associated with change in HbA1c (P = 0.01).
"DD can be successfully reduced among distressed individuals with T1D with elevated HbA1c using both education/behavioral and emotion-focused approaches. Reductions in DD are only modestly associated with reductions in HbA1c," the authors write. "These findings point to the importance of tailoring interventions to address affective, knowledge, and cognitive skills when intervening to reduce DD and improve glycemic control."
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