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Diabetes-management empowermentintervention “youth for adolescents with type 1diabetes

Background:Education, motivation, patient empowerment andsupport are the cornerstones of management of patients with type1 diabetes (T1D). Given the increasing importance of peer relation-ships and role-models in adolescence, peer support has beenrecognized as an important factor that can affect compliance inadolescents with chronic illness.Objectives:To present diabetes-management empowerment inter-vention for adolescents with poor metabolic control and to evaluate their improvement in psychological adjustment, self-efficacy andmetabolic control.Methods:Thirty-two adolescents aged 13– 18 years with poorlycontrolled T1D (HbA1c>8.5%) were enrolled in the program“Youthfor adolescents with T1D”lasting 9 months. Intervention includedmonthly group meetings moderated by doctor and psychologist andmentorship program. Each participant was assigned a mentor- ayoung diabetic patient with excellent glycemic control. Participantswere encouraged to communicate to their mentors on a daily basisusing Facebook group.HbA1c levels were measured at the beginning, at the endof the program and 6 month afterwards. Psychological adjust-ment to diabetes and self-efficacy were evaluated at thebeginning and at the end of the program using ACC-19 and CIDSquestionnaires.Results:Eighteen (56%) patients completed the program. At the endof the intervention they showed improvement in self- efficacy(t=3.977, p<0.01) and had lower HbA1c level (10.12 vs 9.26% ; t=2.613, p<0.05). Psychological adjustment to diabetes did notchange. Six months after the intervention, HbA1c was still lowerthen at the beginning, although not significantly. During studiedperiod, there was no change in HbA1c in dropouts.Conclusion:Intervention programs involving peer-mentors mighthelp adolescents with poor glycemic control to achieve better self-efficacy and improve metabolic control. However, in spite ofnumerous motivational activities through the program, we encoun-tered poor compliance.

type 1 diabetes, youth, interventions

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