Family therapy helps kids with diabetes

Specially tailored family therapy can help teens with type 1 diabetes keep their blood sugar levels under control. Good family communication and problem-solving skills are important for helping young people with type 1 diabetes to manage the condition. Researchers from Nemours Children's Clinic in Jacksonville, Florida, USA, developed a family-based behavioural therapy programme specifically tailored to address diabetes-related family issues. The programme consisted of 12 sessions offered over six months, and included training in behavioural contracting techniques for family members and a 1-week parental simulation of living with type 1 diabetes. The researchers randomly assigned 104 families of teens with poorly controlled type 1 diabetes to the behavioural family therapy program, standard care, or a multifamily support group that included educational elements. While levels of HbA1C (Glycosylated Haemoglobin – a measure of the average blood glucose levels of past three months) fell in all three groups over the first six months, HbA1C levels climbed again in the standard-care and support-group kids, but remained low for the behavioural family therapy group up to 18 months after the programme began. However, the 12-session programme was expensive and complex, making widespread use impractical. Adapting the programme to make the intervention less labour intensive, and, thus, less expensive, might be valuable. The above results support the efficacy of a family-based behavioural therapy approach in improving diabetes control, but further research is needed to identify the mechanisms of this effect and to achieve cost-effective dissemination of this intervention.