PROBLEM-SOLVING TRAINING TO ENHANCE DIETARY SELF-MANAGEMENT IN A DIABETIC PATIENT

A central aspect of self-management of diabetes involves patients regu lating the timing and intake of dietary carbohydrates. A 20 year old f emale diabetic patient was taught to identify deviations from appropri ate dietary self-management, and a problem solving intervention was us ed to train new behavior in settings associated with such deviations. Dietary behavior and blood glucose levels were monitored in a diary an d electronically, and treatment effects were evaluated in a multiple b aseline across settings design. Treatment resulted in clear improvemen t in dietary management, and a substantial gain in blood glucose contr ol at the end of intervention. At follow-up dietary change was maintai ned. Long term effects on blood glucose levels were confounded by a re duction in insulin dosage between treatment and follow-up.