AIM: To investigate whether assigning young, healthy and motivated lay volunteer partners ("buddies") to adolescents with type 2 diabetes improves hemoglobin A1c (HbA1c). METHODS:Adolescents with type 2 diabetes were randomized to partnering with a "buddy" or to conventional treatment. During the initial screening visit, which coincided with a routine outpatient diabetes clinic visit, patients with type 2 diabetes underwent a physical examination, detailed medical history, laboratory measurement of HbA1c, and completed two questionnaires (Pediatric Quality of Life Inventory and Children's Depression Inventory) to assess their overall quality of life and the presence of depressive symptoms. Patients were then randomized to the intervention (the buddy system) or conventional treatment (standard care). All patients were scheduled to return for follow-up at 3- and 6-mo after their initial visit. HbA1c was determined at all visits (i.e., at screening and at the 3- and 6-mo follow-up visits) and quality of life and depressive symptoms were evaluated at the screening visit and were reassessed at the 6-mo visit. RESULTS:Ten adolescents, recruited from a pool of approximately 200 adolescents, enrolled over a two-year time period, leading to premature termination of the study. In contrast, we easily recruited motivated lay volunteers. We found no change in HbA1c from the initial to the 6-mo visit in either group, yet our small sample size limited systematic assessment of this outcome. Participants repeatedly missed clinic appointments, failed to conduct self-glucose-monitoring and rarely brought their glucometers to clinic visits. Total quality of life scores (72.6 ± 6.06) at screening were similar to previously reported scores in adolescents with type 2 diabetes (75.7 ± 15.0) and lower than scores reported in normal-weight (81.2 ± 0.9), overweight (83.5 ± 1.8), and obese youths without diabetes (78.5 ± 1.8) or in adolescents with type 1 diabetes (80.5 ± 13.1). Among adolescents who returned for their 6-mo visit, there were no differences in total quality of life scores (70.2 ± 9.18) between screening and follow-up. CONCLUSION: Our approach, effective in adults with type 2 diabetes, was unsuccessful among adolescents and emphasizes the need for innovative strategies for diabetes treatment in adolescent patients.
RCT Entities:
AIM: To investigate whether assigning young, healthy and motivated lay volunteer partners ("buddies") to adolescents with type 2 diabetes improves hemoglobin A1c (HbA1c). METHODS: Adolescents with type 2 diabetes were randomized to partnering with a "buddy" or to conventional treatment. During the initial screening visit, which coincided with a routine outpatientdiabetes clinic visit, patients with type 2 diabetes underwent a physical examination, detailed medical history, laboratory measurement of HbA1c, and completed two questionnaires (Pediatric Quality of Life Inventory and Children's Depression Inventory) to assess their overall quality of life and the presence of depressive symptoms. Patients were then randomized to the intervention (the buddy system) or conventional treatment (standard care). All patients were scheduled to return for follow-up at 3- and 6-mo after their initial visit. HbA1c was determined at all visits (i.e., at screening and at the 3- and 6-mo follow-up visits) and quality of life and depressive symptoms were evaluated at the screening visit and were reassessed at the 6-mo visit. RESULTS: Ten adolescents, recruited from a pool of approximately 200 adolescents, enrolled over a two-year time period, leading to premature termination of the study. In contrast, we easily recruited motivated lay volunteers. We found no change in HbA1c from the initial to the 6-mo visit in either group, yet our small sample size limited systematic assessment of this outcome. Participants repeatedly missed clinic appointments, failed to conduct self-glucose-monitoring and rarely brought their glucometers to clinic visits. Total quality of life scores (72.6 ± 6.06) at screening were similar to previously reported scores in adolescents with type 2 diabetes (75.7 ± 15.0) and lower than scores reported in normal-weight (81.2 ± 0.9), overweight (83.5 ± 1.8), and obese youths without diabetes (78.5 ± 1.8) or in adolescents with type 1 diabetes (80.5 ± 13.1). Among adolescents who returned for their 6-mo visit, there were no differences in total quality of life scores (70.2 ± 9.18) between screening and follow-up. CONCLUSION: Our approach, effective in adults with type 2 diabetes, was unsuccessful among adolescents and emphasizes the need for innovative strategies for diabetes treatment in adolescent patients.
Entities:
Keywords:
Adolescent; Diabetes mellitus type 2; Hemoglobin A1c; Quality of life; Social support
Authors: Kenneth C Copeland; Philip Zeitler; Mitchell Geffner; Cindy Guandalini; Janine Higgins; Kathryn Hirst; Francine R Kaufman; Barbara Linder; Santica Marcovina; Paul McGuigan; Laura Pyle; William Tamborlane; Steven Willi Journal: J Clin Endocrinol Metab Date: 2010-10-20 Impact factor: 5.958
Authors: Mary Jane Rotheram-Borus; Mark Tomlinson; Margaret Gwegwe; W Scott Comulada; Neal Kaufman; Marion Keim Journal: Diabetes Educ Date: 2012-04-30 Impact factor: 2.140
Authors: M Vervloet; L van Dijk; J Santen-Reestman; B van Vlijmen; P van Wingerden; M L Bouvy; D H de Bakker Journal: Int J Med Inform Date: 2012-05-30 Impact factor: 4.046
Authors: Joel B Braunstein; Noëlle S Sherber; Steven P Schulman; Eric L Ding; Neil R Powe Journal: Medicine (Baltimore) Date: 2008-01 Impact factor: 1.889
Authors: Akihiro Nishi; Danny A Milner; Edward L Giovannucci; Reiko Nishihara; Andy S Tan; Ichiro Kawachi; Shuji Ogino Journal: Expert Rev Mol Diagn Date: 2015-12-04 Impact factor: 5.225