THR1VE!: Randomized controlled trial to reduce diabetes distress in adolescents with type 1 diabetes

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2025-07-16 DOI:10.1111/dme.70107

Sarah S. Jaser, Karishma Datye, James C. Slaughter, Lauren LeStourgeon, Randi Streisand

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Abstract

Aims

To evaluate the effects of a positive psychology intervention to treat diabetes distress (DD) and improve glycaemic outcomes among adolescents with type 1 diabetes.

Methods

Adolescents ages 13–17 with elevated DD and their caregivers from 2 sites (n = 198 dyads) were randomized to receive enhanced usual care (Diabetes Education) or a Diabetes Education + Positive Affect intervention, delivered via automated text messages. Psychosocial and glycaemic data were collected at baseline, 3 months, 6 months and 12 months. The primary outcomes were changes in diabetes distress (DD) and HbA1c over 12 months.

Results

Adolescents demonstrated high levels of engagement in the trial; overall response to text messages was 91%, and retention was 90% over 12 months. Adolescents in both groups reported reductions in DD from baseline to 12 months (effect size d = 0.40), and they were significantly more likely to move from clinically relevant levels into the normal range of DD than to report increased DD (OR = 2.2, p = 0.002). Adolescents' HbA1c was stable over 12 months. We did not observe significant differences in outcomes between groups. Improvement in DD was associated with decreased HbA1c over time (β = 1.89, p = 0.02).

Conclusions

There was no significant intervention effect on DD or HbA1c. Adolescents in both the Diabetes Education and Diabetes Education + Positive Affect arms reported reduced DD over 12 months. Future studies are needed to determine how to employ the least burdensome, engaging intervention for distressed adolescents.

Abstract Image

查看原文本刊更多论文

THR1VE !：减少青少年1型糖尿病患者糖尿病困扰的随机对照试验。

目的：评价积极心理干预对青少年1型糖尿病患者糖尿病困扰（DD）的治疗效果和改善血糖结局的效果。方法：来自2个地点（n = 198对）的13-17岁DD升高的青少年及其照顾者随机接受强化常规护理（糖尿病教育）或糖尿病教育+积极影响干预，通过自动短信传递。在基线、3个月、6个月和12个月时收集社会心理和血糖数据。主要结局是12个月内糖尿病窘迫（DD）和HbA1c的变化。结果：青少年在试验中表现出高水平的参与；短信的总体回复率为91%，12个月的留存率为90%。两组青少年从基线到12个月的DD均有所减少（效应值d = 0.40），并且他们从临床相关水平进入DD正常范围的可能性明显高于报告DD增加的可能性（OR = 2.2, p = 0.002）。青少年HbA1c在12个月内保持稳定。我们没有观察到组间结果的显著差异。随着时间的推移，DD的改善与HbA1c的降低相关（β = 1.89, p = 0.02）。结论：干预对DD和HbA1c无显著影响。糖尿病教育组和糖尿病教育+积极影响组的青少年在12个月内都报告了DD的减少。未来的研究需要确定如何采用负担最少的，参与干预的困扰青少年。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”