Variations of issues related to the self-management of diabetes are a staple of the literature. A study by Nansel and coworkers looked at the social-cognitive, behavioral, and physiological outcomes of a self-management intervention for youth with type 1 diabetes. Participants with type 1 diabetes between the ages of 11 to 16 were randomized to usual care versus a "diabetes personal trainer" intervention. The latter consisted of six self-monitoring, goal setting, and problem solving sessions with trained nonprofessionals. Assessments were completed at baseline and multiple follow-up intervals. Hemoglobin A1c data were obtained from medical records. Results showed that at both short-term and one-year follow-up, there was a nonsignificant trend for an overall intervention effect on A1c, and a significant intervention-by-age interaction, indicating a great effect among older than younger youths. Subgroup analyses found no treatment-group difference among younger youth, but a significant difference among the older youth. No treatment-group differences in parent or youth report of adherence were observed.

VALUE OF STUDY: The authors concluded that the diabetes personal trainer intervention demonstrated significant effects on hemoglobins A1c among middle adolescents. This is not what was found, however, as some findings were not statistically significant. Furthermore, there are two other weaknesses to the study: First, the term “diabetes personal trainer” is little more then fluff: what really took place was that the patients in the intervention group received limited self-management training. Second, a follow-up of one year is not appropriate for a diabetes intervention (nor for any intervention for a chronic illness). Long-term follow-up data is required to assess self-management interventions in these populations. Using more established self-management programs for diabetes would likely have produced more robust results.

T.R. Nansel et al. Diabetes Personal Trainer Outcomes: Short-term and One-year Outcomes of a "Diabetes Personal Trainer" Intervention among Youth with Type I Diabetes. Diabetes Care, 2007, July 9.