This study was designed to evaluate the effects of a self-management training (SMT) program on metabolic control of children with insulin-dependent diabetes mellitus (IDDM) in the first 2 yr after diagnosis. After standard in-hospital diabetes education, 36 children (mean age 9.3 yr, range 3–16 yr) were randomized to conventional follow-up, conventional and supportive counseling (SC), or conventional and SMT, which emphasized use of data obtained from self-monitoring of blood glucose. SC and SMT interventions consisted of seven outpatient sessions with a medical social worker during the first 4 mo after diagnosis and booster sessions at 6 and 12 mo postdiagnosis. Groups were similar with respect to age, sex, body mass index, socioeconomic status, C-peptide, and severity of illness at diagnosis. Metabolic control, measured quarterly by glycosylated hemoglobin (HbA1), improved substantially in all three treatment groups during the first 6 mo. SMT patients had significantly lower HbA1 levels than conventional patients at 1 yr (P < 0.01) and 2 yr (P < 0.05) postdiagnosis. SMT patients also had lower HbA1 levels than SC patients, but this did not reach statistical significance. The lower HbA1 levels of SMT patients were not explained by severity of illness at diagnosis, or insulin dose, body mass index, and C-peptide levels at 2 yr. These results suggest that an SMT program during the first few months after diagnosis helps avoid the deterioration in metabolic control often seen in children with IDDM between 6 and 24 mo after diagnosis.
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Original Articles|
May 01 1990
Randomized Prospective Study of Self-Management Training With Newly Diagnosed Diabetic Children
Alan M Delamater, PhD;
Alan M Delamater, PhD
State University
Detroit
University of Michigan
Ann Arbor, Michigan
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine
St. Louis, Missouri
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Jeanne Bubb, MSW;
Jeanne Bubb, MSW
State University
Detroit
University of Michigan
Ann Arbor, Michigan
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine
St. Louis, Missouri
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Susan G Davis, MSN;
Susan G Davis, MSN
State University
Detroit
University of Michigan
Ann Arbor, Michigan
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine
St. Louis, Missouri
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Jeffrey A Smith, PhD;
Jeffrey A Smith, PhD
State University
Detroit
University of Michigan
Ann Arbor, Michigan
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine
St. Louis, Missouri
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Lois Schmidt, RD;
Lois Schmidt, RD
State University
Detroit
University of Michigan
Ann Arbor, Michigan
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine
St. Louis, Missouri
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Neil H White, MD;
Neil H White, MD
State University
Detroit
University of Michigan
Ann Arbor, Michigan
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine
St. Louis, Missouri
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Julio V Santiago, MD
Julio V Santiago, MD
State University
Detroit
University of Michigan
Ann Arbor, Michigan
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine
St. Louis, Missouri
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Address correspondence and reprint requests to Alan M. Delamater, PhD, Department of Psychology, Wayne State University, 71 West Warren Avenue, Detroit, Ml 48202.
Diabetes Care 1990;13(5):492–498
Article history
Received:
August 21 1989
Revision Received:
November 29 1989
Accepted:
November 29 1989
PubMed:
2351027
Connected Content
A correction has been published:
Erratum
Citation
Alan M Delamater, Jeanne Bubb, Susan G Davis, Jeffrey A Smith, Lois Schmidt, Neil H White, Julio V Santiago; Randomized Prospective Study of Self-Management Training With Newly Diagnosed Diabetic Children. Diabetes Care 1 May 1990; 13 (5): 492–498. https://doi.org/10.2337/diacare.13.5.492
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