Evaluation of a structured type 1 diabetes education program for adolescents and parents: Teens Empowered to Actively...

To examine changes in psychological and clinical outcomes among adolescents and parents after structured type 1 diabetes education delivered in routine care.

Teens Empowered to Actively Manage Type 1 Diabetes (TEAM T1) is a psycho-educational program (adolescents: 5-day; parents: 2-day), designed to teach adolescents (aged 12-19) and parents flexible, intensive insulin therapy and adaptive coping with diabetes. A quasi-experimental design assessed diabetes distress (DD) (PAID: teen and parent versions), diabetes management self-efficacy (DMSE), diabetes-related family conflict (DRFC: two items), and HbA1c at baseline, 3- and 12-month post-program.

In total, 207 adolescents and 207 parents completed TEAM T1 (86% attended the full program; 178 adolescents, mean age 16 ± 1 years, 54% (n = 96) female) and 125 parents (86% (n = 108) mothers) completed baseline questionnaires. There was no change in DD, DRFC or HbA1c (p ≥ 0.05). However, at 3 months, DMSE increased (0.14, p < 0.008), and among 78 (48%) adolescents with elevated baseline DD (PAID-T ≥70), DD decreased (-7.36, p = 0.025). HbA1c decreased among those with high baseline HbA1c (>75 mmol/mol; 9.0%); 34%, n = 56; p = 0.002 but increased among those <75 mmol/mol (p = 0.001). Parental DD decreased at 3 months (-6.3, p = 0.014), and item analysis showed a significant decrease in parental concerns about the child's food and eating and glucose levels (d = 2.7-3.2, p < 0.04). At 12 months, differences were not significant.

Overall, HbA1c and psychological outcomes did not improve significantly, although DD and HbA1c decreased among adolescents with elevated levels at baseline. The emphasis on monitoring food and blood glucose did not worsen DD and may have a positive impact on family relationships and body weight concerns.