Coping skills training for youth with diabetes mellitus has long-lasting effects on metabolic control and quality of life

Objective: To determine whether initial effects on metabolic control and qu ality of life associated with a behavioral intervention combined with inten sive diabetes management (IDM) can be sustained over 1 year in youth implem enting intensive therapy regimens. Study design: Seventy-seven patients (43 females, 95% white) 12 to 20 years (mean = 14.2 +/- 1.9; duration, 8.7 +/- 3.9) electing to initiate IDM were randomly assigned to one of two groups: with or without coping skills trai ning (CST), which consists of G small group sessions and monthly follow-up to help youth cope with their lives in the context of diabetes management; skills included social problem solving, cognitive behavior modification, an d conflict resolution. Data were collected before the intervention and at 3 , 6, and 12 months after the intervention LSI using the Self-Efficacy for D iabetes Scale, Children's Depression Inventory, Issues in Coping with IDDM, and the Diabetes Quality of Life: Youth scales. Clinical data (glycosylate d hemoglobin level, height, weight, adverse effects) were collected monthly . Results: The CST and IDM groups were comparable at baseline. CST subjects h ad lower glycosylated hemoglobin (P =.001) and better diabetes (P =.002) an d medical (P =.04) self-efficacy, and less impact of diabetes on their qual ity of life (P =.005) than youth receiving IDM alone after 1 year. In males , CST did not affect adverse outcomes of IDM hypoglycemia, diabetic ketoaci dosis, and weight gain, but CST decreased the incidence of weight gain (P = .05) and hypoglycemia in females (P =.03). Conclusions: The addition of behavioral intervention to IDM in adolescence results in improved metabolic control and quality of life over 1 year.