Randomized prospective study of self-management training with newly diagnosed diabetic children

Alan M. Delamater, Jeanne Bubb, Susan C. Davis, Jeffrey A. Smith, Lois Schmidt, Neil H. White, Julio V. Santiago

Research output: Contribution to journalArticle

118 Scopus citations

Abstract

This study was designed to evaluate the effects of a self-management training (SMT) program on metabolic control of children with insulin-dependent diabetes mellitus (IDDM) in the first 2 yr after diagnosis. After standard in-hospital diabetes education, 36 children (mean age 9.3 yr, range 3-16 yr) were randomized to conventional follow-up, conventional and supportive counseling (SC), or conventional and SMT, which emphasized use of data obtained from self-monitoring of blood glucose. SC and SMT interventions consisted of seven outpatient sessions with a medical social worker during the first 4 mo after diagnosis and booster sessions at 6 and 12 mo postdiagnosis. Groups were similar with respect to age, sex, body mass index, socioeconomic status, C-peptide, and severity of illness at diagnosis. Metabolic control, measured quarterly by glycosylated hemoglobin (HbA1), improved substantially in all three treatment groups during the first 6 mo. SMT patients had significantly lower HbA, levels than conventional patients at 1 yr (P < 0.01) and 2 yr (P < 0.05) postdiagnosis. SMT patients also had lower HbA1 levels than SC patients, but this did not reach statistical significance. The lower HbA, levels of SMT patients were not explained by severity of illness at diagnosis, or insulin dose, body mass index, and C-peptide levels at 2 yr. These results suggest that an SMT program during the first few months after diagnosis helps avoid the deterioration in metabolic control often seen in children with IDDM between 6 and 24 mo after diagnosis.

Original languageEnglish (US)
Pages (from-to)492-498
Number of pages7
JournalDiabetes care
Volume13
Issue number5
DOIs
StatePublished - May 1990
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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    Delamater, A. M., Bubb, J., Davis, S. C., Smith, J. A., Schmidt, L., White, N. H., & Santiago, J. V. (1990). Randomized prospective study of self-management training with newly diagnosed diabetic children. Diabetes care, 13(5), 492-498. https://doi.org/10.2337/diacare.13.5.492