Long-Term Maintenance of Treatment Outcomes: Diabetes Personal Trainer Intervention for Youth With Type 1 Diabetes

  1. Tonja R. Nansel, PHD1,
  2. Ronald J. Iannotti, PHD1,
  3. Bruce G. Simons-Morton, EDD1,
  4. Leslie P. Plotnick, MD2,
  5. Loretta M. Clark, RN, CDE2 and
  6. Linda Zeitzoff, CPNP, CDE3
  1. 1Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland;
  2. 2Department of Pediatric Endocrinology, Johns Hopkins Medical Center, Baltimore, Maryland;
  3. 3Mount Washington Pediatric Hospital, Baltimore, Maryland.
  1. Corresponding author: Tonja Nansel, nanselt{at}mail.nih.gov

Abstract

OBJECTIVE To describe a 2-year follow-up of A1C outcomes of a self-regulation intervention for youth with type 1 diabetes.

RESEARCH DESIGN AND METHODS A total of 81 youths with type 1 diabetes ages 11–16 years were randomized to usual care versus a diabetes personal trainer intervention consisting of six self-monitoring, goal-setting, and problem-solving sessions with trained nonprofessionals. A1C data were obtained from medical records 2 years postintervention, and ANCOVA adjusting for age and baseline A1C was conducted.

RESULTS An overall intervention effect on A1C (8.93% control vs. 8.43% intervention; F = 8.24, P = 0.05) and a significant intervention-by-age interaction (F = 9.88; P = 0.002) were observed, indicating a greater effect among older than younger youths. Subgroup analyses demonstrated no treatment group differences among pre-/early adolescents but a significant difference in A1C among middle adolescents (9.61% control vs. 8.46% intervention; F = 7.20, P = 0.011).

CONCLUSIONS Findings indicate maintenance of intervention effects on A1C observed at 1-year follow-up.

Footnotes

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received October 31, 2008.
    • Accepted January 18, 2009.

  • Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

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  1. Published online before print February 10, 2009, doi: 10.2337/dc08-1968 Diabetes Care May 2009 vol. 32 no. 5 807-809
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