T1-REDEEM: A Randomized Controlled Trial to Reduce Diabetes Distress Among Adults With Type 1 Diabetes

Area of Science:

• Endocrinology
• Psychology
• Behavioral Medicine

Background:

• Diabetes distress (DD) significantly impacts adults with type 1 diabetes (T1D), affecting glycemic control.
• Effective interventions are needed to manage DD and improve health outcomes in this population.

Purpose of the Study:

• To compare the effectiveness of an emotion-focused intervention (OnTrack) versus an educational/behavioral intervention (KnowIt) for reducing DD and improving glycemic control in adults with T1D.

Main Methods:

• 301 adults with T1D and elevated DD/HbA1c were randomized to OnTrack or KnowIt.
• Both interventions included a workshop and online meetings over 3 months.
• Assessments of DD and HbA1c were conducted at baseline, 3, and 9 months.

Main Results:

• Both interventions significantly reduced DD (effect size d = 1.06), with no between-group differences.
• OnTrack was more effective for individuals with poorer regulation skills, higher baseline DD, or greater initial knowledge.
• Modest reductions in HbA1c were observed in both groups, with no significant differences between them.

Conclusions:

• Both educational/behavioral and emotion-focused interventions can successfully reduce DD in adults with T1D.
• DD reduction is only modestly associated with HbA1c improvement.
• Intervention tailoring based on affective, knowledge, and cognitive skills is crucial for optimizing outcomes.