The effects of targeting improvements in urine glucose on metabolic control in children with insulin dependent diabetes.

A treatment program designed to increase the percentage of negative urine tests was implemented using a multiple-baseline across groups design in a sample of 19 families of children with insulin dependent diabetes. The treatment involved instruction in insulin adjustment, decrease in intake of simple sugars and saturated fats, and increase in exercise, along with teaching the parents to support improvements in children's self-regulatory behaviors using a point economy and praise. New procedures designed to measure and reinforce adherence to the urine testing regimen were developed. Results showed significant increases in percentage of negative urines consistent with implementation of treatment across the three treatment groups, which were maintained over the follow-up period. Metabolic measures of control, including glycosylated hemoglobin and serum glucose did not show improvements even though the relationship between the percentage of negative urine tests and glycosylated hemoglobin was very high during treatment.