Effects of cognitive behavioural group training (CBGT) in adult patients with poorly controlled insulin-dependent (type 1) diabetes: a pilot study

A substantial group of patients with type 1 diabetes has difficulty adherin g to the treatment regimen, and as a consequence is at increased risk of de veloping microvascular complications. Cognitive behavioural interventions m ay help these patients to cope more effectively with their diabetes. We dev eloped a 4 weeks cognitive behavioural. group training (CBGT) for patients with type I (insulin-dependent) diabetes in persistent poor glycaemic contr ol, to help them overcome negative beliefs and attitudes towards diabetes a nd improve their self-care behaviours. Feasibility and efficacy of CBGT wer e tested in a non-randomised prospective study in 24 poorly-controlled type I diabetes patients (mean age 35.2 +/- 11.1 years; 15 female; mean HbA(1c) 9.3% (+/-1.2)), with assessments at 3 and 6 months follow-up. The program- me was delivered in small groups (n = 6-8), by a team of a diabetes nurse s pecialist and a psychologist. Primary outcome measures were glycosylated ha emoglobin (HbA1(c)), diabetes-related emotional distress (PAID) and psychol ogical well-being (WBQ-12). Chang diabetes self-care activities (DSCI) were documented, along with perceived barriers in diabetes questionniare (BDQ) and fear of hypoglycaemia survey (HFS). Data were analysed using repeated m easures analysis of variance. The CBGT proved to be feasible in this select ed group of patients and was well appreciated. Following CBGT, mean HbA(1c) dropped by 0.8% at 6 months from baseline, while emotional well-being was preserved, It is concluded that CBGT is a promising intervention that deser ves further evaluation in randomised controlled trials. (C) 2001 Elsevier S cience Ireland Ltd. All rights reserved.