Introduction and Objective: Maternal caregivers of adolescents with type 1 diabetes (T1D) experience elevated levels of depressive symptoms and diabetes distress, which are established risk factors for poor psychosocial and glycemic outcomes in adolescents. We evaluated the effects of a cognitive behavioral intervention for distressed caregivers in a randomized controlled trial.Methods: Maternal caregivers of adolescents with T1D (n=151, mean adolescent age=14+2yrs, 56% female, 85% non-Hispanic White, mean HbA1c=9.0+2.1%), were randomized to receive a cognitive behavioral intervention (Communication & Coping) targeting coping skills and positive parenting strategies or an Enhanced Diabetes Education intervention. Participants in both groups received intervention materials and completed up to 7 phone sessions with a trained interventionist over 3 months, with concurrent daily Facebook posts designed to reinforce the concepts for each intervention. Psychosocial and glycemic data were collected over 12 months.Results: Caregivers in both groups reported significant decreases in depressive symptoms (effect size d=3.5, p<.001) and diabetes distress (d=0.6, p<.001) over 12 months, with no significant differences between groups. Adolescents experienced improvements in quality of life (d =-2.95, p<.001), with marginally higher scores in the Education group (p=.048). Adolescents maintained HbA1c (8.9% at 12 months), with no significant difference between groups.Conclusion: Interventions for caregivers are effective in treating maternal distress and improving quality of life in adolescents with T1D. Specific intervention materials may be less critical than repeated interactions with trained interventionists that address maternal caregivers’ concerns about raising an adolescent child with T1D.
S.S. Jaser: None. J.H. Simmons: Consultant; Boehringer-Ingelheim. Research Support; Kyowa Kirin Co., Ltd. Consultant; Kyowa Kirin Co., Ltd. Advisory Panel; Ultragenyx. Research Support; Ultragenyx, Alexion.
National Institutes of Health (R01DK115545)
Source link
Leave a Reply