Researchers from the University of California, San Francisco (UCSF) reported that the results of their study—recently published in Diabetes Care—demonstrated that both group-based and fully virtual programs are effective in reducing diabetes distress and improving glycosylated hemoglobin A1C (HbA1c). The researchers also informed that there is value in the emotion-focused strategies based within a psychologist-led program that focuses exclusively on the emotional side of diabetes and that it can further enhance care for adults with type 1 diabetes (T1D).

First author of the study, Danielle Hessler Jones, PhD, professor, vice chair for research in the UCSF Department of Family and Community Medicine, and fellow researchers embarked upon a journey to compare three ways of reducing what they termed diabetes distress (DD) to improve HbA1c measurements in adults diagnosed with T1D. According to the authors, DD refers to “the fears, worries, and burdens associated with living with and managing diabetes and that among adults with T1D, elevated DD is highly prevalent (42-77%).”

To evaluate DD and its impact, the team evaluated 276 subjects with T1D who also had elevated DD based on a score >2 on the total Type 1 Diabetes Distress Scale and HbA1c >7.5%. The subjects were randomly assigned to one of three virtual group-based programs: 1) Streamline, an educator-led education and diabetes self-management program; 2) TunedIn, a psychologist-led program focused exclusively on emotional-focused DD reduction; or 3) FixIt, an integration of Streamline and TunedIn. Assessments of HbA1c and DD occurred at baseline and at 3, 6, and 12 months.

The team found that all three interventions were linked with clinically meaningful improvements in both DD and HbA1c but that the emotion-focused program had the most consistent benefits of sustained reduction in DD (Cohen’s d = 0.58-1.14) and HbA1c (range, 20.4-20.72) at 12-month follow-up. Both FixIt and TunedIn participants reported significantly greater DD reductions compared with Streamline participants (P = .007); however, Streamline and TunedIn participants achieved significantly greater HbA1c reductions than did the subjects in the FixIt group (P = .006).

According to Dr. Hessler Jones, “Most patients with diabetes have never heard of diabetes distress or been asked about it, and don’t understand that it can be alleviated. Knowing virtual group-based programs are effective presents an opportunity to change that.”

“Providing individuals with type 1 diabetes with opportunities to recognize and observe these processes, and to ‘stand beside them,’ may enable them to make different choices, choices that can have positive impacts on their health and well-being,” Dr. Hessler Jones added.

The authors concluded, “DD can be successfully reduced among individuals with T1D with elevated HbA1c using both the educational/behavioral and emotion-focused approaches included in the study. The study findings suggest the overall value of group-based, fully virtual, and time-limited emotion-focused strategies, like those used in TunedIn, for adults with T1D.”

According to coauthor of the research publication, Umesh Masharani, MBBS, and a UCSF professor of endocrinology, “It’s important that clinicians are trained on how to have these conversations with their patients with diabetes as part of normal care. If you don’t address the emotional part of living with the illness, you don’t do well.”

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.