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Type I diabetes: motivational enhancement therapy delivered with CBT by nurse therapists to people with type I diabetes leads to lowering of HbA1C values

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Question

Question

Does motivational enhancement therapy (MET) with or without cognitive behavioural lead to improved glycaemic control in people with type I diabetes?

Patients

344 adults (18–65 years) with type 1 diabetes for a minimum duration of 2 years, defined as onset at younger than 35 years of age, a current glycated haemoglobin (HbA1C) value between 8.2% and 15.0% and onset of insulin therapy within 6 months of diagnosis or ketones in the urine. The patients had diabetes for a median of 18 years.

Setting

London and Greater Manchester; September 2003 and August 2005.

Intervention

MET or a combination of MET and cognitive–behaviour therapy (CBT), both groups also had usual diabetes care. These groups were compared to usual care alone. The interventions were delivered by nurse therapists and were developed by the researchers.

Outcomes

Primary outcome was HbAlc at 12 months from randomisation. Secondary outcomes included 1 year costs assessed by the Client Service Receipt Inventory at baseline, 6 months and 12 months and quality-adjusted life years (QALYs) at baseline and 12 months.

Patient follow-up

88%.

Methods

Design

Randomised controlled trial.

Allocation

Concealed.

Blinding

Single blind; …

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