Family therapy helps kids with type 1 diabetes

NEW YORK (Reuters Health) - Specially tailored family therapy can help teens with type 1 diabetes keep their blood sugar levels under control.

However, the 12-session program is expensive and complex, making widespread use impractical, Dr. Tim Wysocki of the Nemours Children's Clinic in Jacksonville, Florida and colleagues note. "Adapting (the program) to make the intervention less labor intensive, and, thus, less expensive, might be valuable," they add.

Good family communication and problem-solving skills are important for helping young people with type 1 diabetes to manage the condition, Wysocki and his team note in the medical journal Diabetes Care.

They developed a family-based behavioral therapy program specifically tailored to address diabetes-related family issues. The program consisted of 12 sessions offered over six months, and included training in "behavioral contracting" techniques for family members and "a 1-week parental simulation of living with type 1 diabetes."

For their study, the researchers randomly assigned 104 families of teens with poorly controlled type 1 diabetes to the behavioral family therapy program, standard care, or a multifamily support group that included educational elements.

While levels of A1C, a measurement of long-term blood glucose control, fell in all three groups over the first six months, A1C levels climbed again in the standard-care and support-group kids, but remained low for the behavioral family therapy group up to 18 months after the program began.

The results support the efficacy of a family-based behavioral therapy approach in improving diabetes control, the researchers conclude, "but further research is needed to identify the mechanisms of this effect and to achieve cost-effective dissemination of this intervention."

SOURCE: Diabetes Care, March 2007.