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An internet-based program to improve self-management in adolescents with type 1 diabetes
Shelagh A Mulvaney1, Russell L Rothman, Kenneth A Wallston
1School of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee, USA. shelagh.mulvaney@vanderbilt.edu
Diabetes Care
|December 25, 2009
Summary
The YourWay internet intervention improved self-management in adolescents with type 1 diabetes. While not statistically significant in all analyses, the intervention helped maintain glycemic control compared to the control group.
Area of Science:
- Endocrinology
- Digital Health
- Adolescent Medicine
Background:
- Type 1 diabetes management in adolescents presents unique challenges.
- Adolescent self-management skills are crucial for glycemic control.
- Internet-based interventions offer a novel approach to support adolescent self-care.
Purpose of the Study:
- To evaluate the effectiveness of YourWay, an internet-based self-management intervention.
- To assess the impact of the intervention on problem-solving and self-management skills.
- To determine the effect on glycemic control (A1C) in adolescents with type 1 diabetes.
Main Methods:
- Randomized controlled trial with 72 adolescents (ages 13-17) with type 1 diabetes.
- Intervention group received usual care plus internet support; control group received usual care.
- Data collected included A1C from medical records and self-reported problem-solving and self-management.
Main Results:
- As-treated analyses showed statistically significant improvement in self-management (d = 0.64; P = 0.02) in the intervention group.
- The intervention group's mean A1C remained stable (-0.01%), whereas the control group's A1C increased (0.33%).
- Improvements in problem-solving (d = 0.30; P = 0.23) and A1C (d = -0.28; P = 0.27) were observed but not statistically significant.
Conclusions:
- Internet-based self-management support may enhance self-management behaviors in adolescents with type 1 diabetes.
- This intervention may help mitigate the typical decline in glycemic control often seen in this age group.
- Secure website delivery of self-management support shows promise for adolescent diabetes care.
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