Research Review

Family Problem-Solving Sessions Help Teens Better Manage Diabetes

A clinic-based program for adolescents with type 1 diabetes and their families helped the teens develop the healthy behaviors needed to control their blood sugar levels, researchers at the National Institutes of Health have found.

The researchers found that 12- to 15-year-olds benefited from a two-year program of three to four meetings each year with parents and a health advisor to discuss shared responsibilities, goals and strategies for solving diabetes management problems that arose. The findings are published online in Pediatrics.

"Adolescence can be difficult for families—even without the complex challenge of taking care of diabetes," says first author Tonja R. Nansel, PhD, of the Prevention Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. "Our study found that meeting with a health advisor during regular diabetes clinic visits could help families put together strategies for dealing with diabetes, to better manage the changes that occur as children take on more responsibility for their day-to-day diabetes care."

Many adolescents have difficulty managing their diabetes. Hormonal changes may affect insulin levels. Moreover, adolescents may find it difficult to adhere to their daily treatment plan.

When caring for their diabetes, adults often follow the patterns they established in adolescence, Nansel explains. If they fail to learn how to care for the disease properly during this time, they may develop poor habits that increase the chances for health problems later on.

In the study, the researchers evaluated WE-CAN Manage Diabetes, a two-year behavioral intervention program they developed. The study included about 300 preteens and young adolescents with type 1 diabetes (aged 9 to 15) and their families. One-half the families received the WE-CAN intervention and one-half received standard care.

Standard care consisted of regular visits with their diabetes care physician. In addition to the physician visits, the WE-CAN program included meetings in which the health advisor discussed with the family any difficulties they were having with the child’s diabetes management or areas they would like to improve. The health advisor then helped the families work out a plan for solving the problems. For example, in their sessions with the health advisor, young people with diabetes and their families frequently set goals such as checking blood sugar more often or eating more healthfully.

At each visit, researchers also recorded hemoglobin A1C (HbA1C) measurements, a standard indicator of a person’s long-term blood sugar control.

At the study's conclusion, the 12- to 15-year-olds in the intervention group had markedly better HbA1c levels than those who received standard care. The intervention did not appear to improve blood sugar control among 9- to 11-year-olds.

“The approach appears to be better suited for the behavioral issues that the older kids were facing,” says Nansel. “The findings show us that the children who needed it most are the ones for whom this approach worked.”

— Source: National Institutes of Health