Nansel and coworkers described two-year follow-up hemoglobin A1c (HbA1c) outcomes of a self-regulation intervention for youth with type 1 diabetes. Eighty-one youths with type 1 diabetes ages 11 to 16 were randomized to usual care versus a "diabetes personal trainer" intervention, consisting of six self-monitoring, goal setting, and problem solving sessions with trained non-professionals. HbA1c data were obtained from medical records two years post-intervention. ANCOVA adjusting for age and baseline HbA1c was conducted. An overall intervention effect on HbA1c (8.93 control versus 8.43 intervention) and a significant intervention-by-age interaction were observed, indicating a greater effect among older than younger youths. Subgroup analyses demonstrated no treatment-group difference among pre/early adolescents, but a significant difference in HbA1c among middle adolescents (9.61 control versus 8.46 intervention).

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that their findings indicate maintenance of intervention effects on HbA1c observed at one-year follow-up.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The findings in this study are not that clear. For example, whereas they conducted a two-year follow-up, they note that maintenance effects were observed at the one-year follow-up. What happened at the two-year follow-up? This may be a mistake in reporting the investigation. What is more important, however, is that the intervention in youth for type I diabetes seemed to have a positive effect. For that reason, it would suggest that if you have type I diabetes, you must learn the self-management skills outlined above to help you control the disease.

TR Nansel et al. Long-Term Maintenance of Treatment Outcomes: "Diabetes Personal Trainer" Intervention for Youth with Type 1 Diabetes. Diabetes Care, February 10, 2009.