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Education and telephone case management for children with type 1 diabetes: a randomized controlled trial

Carol J Howe1, Abbas F Jawad, Alan K Tuttle

  • 1Diabetes Center for Children, The Children's Hospital of Philadephia, PA 19104, USA.

Journal of Pediatric Nursing
|April 9, 2005
PubMed

Insights

Telephone case management improved adherence in children with type 1 diabetes. While glycemic control (HbA1c) did not significantly differ, adherence scores were higher in the education plus telephone case management group.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Nursing

Background:

  • Type 1 diabetes management in children requires effective nursing interventions.
  • Glycemic control is crucial for preventing long-term complications.
  • Parent-child dynamics and knowledge impact diabetes self-care.

Purpose of the Study:

  • To compare the impact of standard care, education, and education plus telephone case management on pediatric type 1 diabetes outcomes.
  • To assess the effectiveness of nursing interventions on glycemic control, knowledge, teamwork, and adherence.

Main Methods:

  • Randomized controlled trial with 75 children (mean age 12.5 years).
  • Three groups: Standard Care (SC), Education (ED), Education + Telephone Case Management (ED + TCM).
  • Primary outcome: Hemoglobin A1c (HbA1c); Secondary: Diabetes Knowledge (KNOW), Teamwork (TEAM), Adherence (ADH).

Main Results:

  • No significant differences in HbA1c among the three groups after 6 months.
  • Slight improvements in KNOW and TEAM in ED and ED + TCM groups, but not statistically significant.
  • Significant improvement in ADH scores for the ED + TCM group compared to SC and ED groups.

Conclusions:

  • Education plus telephone case management enhances adherence in pediatric type 1 diabetes.
  • While direct impact on HbA1c was not significant, improved adherence may lead to better long-term glycemic control.
  • Recruitment and retention challenges in pediatric diabetes research were noted.

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