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Psychological Treatment Improves Hemoglobin A1c Outcomes in Adolescents with Type 1 Diabetes Mellitus

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Abstract

Adolescents diagnosed with Type 1 Diabetes Mellitus often exhibit reduced adherence to their medical regimen and poor glycemic control. A retrospective study examined longitudinal hemoglobin A1c (HgbA1c) outcomes for adolescent patients referred to the psychology service embedded within an endocrinology clinic. Three patient groups were examined: (1) Treatment: 59 adolescents referred who engaged in psychotherapy; (2) No Treatment: 40 adolescents referred yet failed to initiate psychotherapy; (3) Control: 58 adolescents not referred for treatment and matched on demographics to the two treatment groups. Over 1 year, the Treatment group had a sustained decrease in HgbA1c while the No Treatment and Control groups had an overall increase in HgbA1c. At study end, the Treatment group had HgbA1c values that were not significantly different from patients who were not considered in need of psychological treatment (Control). Adolescents that utilized the pediatric psychology service saw decreased HgbA1c values over time.

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Acknowledgments

This study was supported in part by a grant from the American Cancer Society to MK Bean. [PFT-08-144-01-CPPB], which had no involvement with the conduct of the research or preparation of the manuscript. We are grateful to the patients and families who participated in this study.

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Authors and Affiliations

  1. Children’s Hospital of Richmond, 1101 East Marshall Street, Richmond, VA, 23298, USA

    Matthew J. Bitsko, Melanie K. Bean & Gary L. Francis

  2. Department of Pediatrics, Children’s Hospital of Richmond, Virginia Commonwealth University, 1101 East Marshall Street, Richmond, VA, 23298, USA

    Matthew J. Bitsko, Melanie K. Bean & Gary L. Francis

  3. Department of Psychology, Virginia Commonwealth University, 1101 East Marshall Street, Richmond, VA, 23298, USA

    Matthew J. Bitsko & Melanie K. Bean

  4. Yeshiva of Greater Washington, 2010 Linden Lane, Silver Spring, MD, 20902, USA

    Sarah Bart

  5. Department of Psychology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA

    Rebecca H. Foster

  6. Department of Biostatistics, School of Medicine, Virginia Commonwealth University, 830 East Main Street, One Capitol Square, 7th Floor, Richmond, VA, 23298, USA

    Leroy Thacker

  7. Department of Pediatrics, Virginia Commonwealth University, PO Box 980440, Richmond, VA, 23298-0440, USA

    Matthew J. Bitsko

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  1. Matthew J. Bitsko
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  2. Melanie K. Bean
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Correspondence to Matthew J. Bitsko.

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Bitsko, M.J., Bean, M.K., Bart, S. et al. Psychological Treatment Improves Hemoglobin A1c Outcomes in Adolescents with Type 1 Diabetes Mellitus. J Clin Psychol Med Settings 20, 333–342 (2013). https://doi.org/10.1007/s10880-012-9350-z

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