Adolescents with poorly controlled Diabetes do better with a program of intensive, home-based, family-centered psychotherapy, according to new research.

Teens with Type 1 Diabetes, which requires regular insulin injections and careful monitoring of blood sugar levels, have been considered “very difficult to manage clinically,” said Dr. Deborah A. Ellis.

“Our study showed that families were willing to receive behavioral treatment when it was provided in their home and that such intensive behavioral interventions can result in improved outcomes,” she said.

In their study, reported in the journal Diabetes Care, Ellis from Wayne State University in Detroit and colleagues randomly assigned 127 adolescents with a history of poorly controlled Type 1 Diabetes to standard medical care only or to standard medical care plus 6 months of an intervention targeting problems related to adherence to diabetes treatment.

The behavioral intervention was successful in improving diabetes control, the team reports. Average long-term blood sugar control improved to a degree that was both statistically significant and clinically meaningful, Ellis and colleagues note.

The strategy led to more frequent blood glucose testing. “Frequent testing of blood glucose has been linked to better metabolic control and may therefore account for the improvements in metabolic control experienced by the group,” the investigators write.

This study shows that home-based therapy “holds promise in improving the diabetes management and metabolic control of adolescents,” the team concludes, but they point out that longer follow up is needed to see whether the effects are long-lasting.

SOURCE: Diabetes Care, July 2005.