Diabetes Personal Trainers Improve Self-Management by Teenagers

According to the results of an NIH study, diabetes personal trainers can enhance an adolescent’s motivation and capability for diabetes self-management.

Dr. Tonja R. Nansel, at the National Institute of Child Health and Human Development in Bethesda, Maryland, and colleagues developed a program to provide young type 1 diabetics with one-on-one interaction with a facilitator to improve self-monitoring, goal-setting, and problem-solving.

The facilitators were called "personal trainers" to "emphasize the development of strengths rather than the amelioration of deficits."  The facilitators received 80 hours of training in the use of motivational interviewing, applied behavior analysis, and problem solving.

Eighty-one subjects with type 1 diabetes, aged 11 to 16 years, were randomly assigned to usual care or to six sessions with a personal trainer. Outcome measures, including glycosylated hemoglobin (A1C), were determined shortly after the end of the intervention (up to 9 months post-baseline) and at a late-term evaluation (10 to 18 months post-baseline).

"There was a trend for an overall intervention effect on A1C," the team reports. However, the between-group difference in A1C was significant (p = 0.02) only in the older subjects, aged 14 to 16 years, at the short-term evaluation.
Otherwise, there were no significant differences between arms of the study in adherence, self-efficacy, outcome expectations, or quality of life.

However, study participants and their parents were enthusiastic about the program, many of them wishing that the intervention had lasted longer.

"The outcomes suggest that self-management skills are a relevant and important target for improving blood glucose control during adolescence," Dr. Nansel’s team concludes.

Diabetes Care Nov, 2007;30:2471-2477.

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FACT:
Chronic Kidney Disease in the U.S. Increased 13%: The estimated prevalence of chronic kidney disease among adults in the U.S. has increased to 13 percent, in part because of the increase in diabetes and hypertension, and less than 1 in 10 individuals with kidney disease are aware they have a problem,” according to a new study.  See This Weeks’ Item #12