Non-pharmacological interventions, like a balanced diet and regular physical activity, could help improve health outcomes in adolescents with type 1 diabetes, according to new data published in the journal Asian Nursing Research.1
According to the CDC, 304000 children and adolescents under the age of 20 in the United States had a diagnosis of type 1 diabetes in 2021.2 Although non-pharmacological interventions, which include a healthy diet, diabetes education, regular physical activity, and psychological and social support, have been shown to improve some diabetes outcomes, the impact on HbA1c levels and psychological outcomes has been inconsistent.
Key Takeaways
- Combining psychological, self-care, and educational interventions significantly improves health outcomes in adolescents with type 1 diabetes, impacting factors like HbA1c, quality of life, anxiety, and blood glucose.
- Effective care for adolescents with diabetes goes beyond clinics; policies should promote non-drug interventions at home, in hospitals, and at school. This ensures continuous and private support for these individuals.
- Adolescents with type 1 diabetes must prioritize glycemic control to prevent long-term complications affecting mood, cognition, and overall development. Non-pharmacological interventions, especially those addressing psychological and self-care aspects, are crucial for achieving and sustaining glycemic control.
“[H]ypoglycemia and hyperglycemia during adolescence can have long-term effects on mood, cognitive function, growth, development, and brain health, persisting into adulthood,” the authors wrote. “Therefore, it is essential for adolescents with type 1 diabetes to prioritize glycemic control, reducing the risk of long-term complications and ensuring overall well-being throughout their lives.”
Investigators from the College of Nursing at Pusan National University in South Korea conducted a meta-analysis to examine the impact of non-pharmacological intervention in adolescents with type 1 diabetes. Studies that were published from 2017 to 2022 were gathered from PubMed, Embase, CINAHL, and Cochrane databases.
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A total of 30 studies were included in the meta-analysis, of which the majority were conducted in the US and Iran. Twenty of the studies reported a mean participant age of 10 to 14 years. A majority of the interventions were conducted in a hospital or outpatient clinic setting, with 17 having a duration of 6 months.
The interventions were classified into 3 types: cognitive and psychological, which included counseling, psychotherapy, cognitive behavioral therapy, and motivational interviewing; self-care behavior management, which included eating habits, physical activity, blood glucose monitoring, medication, diabetes coping skills, and problem solving skills; and education, which included learning and quiz activity.
Investigators found that the non-pharmacological interventions were significantly effective at improving HbA1c, quality of life, anxiety, and blood glucose. Cognitive/psychological and self-care interventions had the highest impact on HbA1c levels, while self-care and education had the highest impact on blood glucose levels.
Self-care and education had the highest impact on levels of anxiety, while self-care, education, and cognitive/psychological interventions had the highest impact on quality of life. Additionally, subgroup analysis showed that the duration of interventions were not a covariate related to HbA1c levels.
Study limitations included that only studies conducted in English were included in the meta-analysis, a significant level of heterogeneity among included studies, and limited number of non-pharmacological interventions included in the subgroup analysis.
“Based on the results of this study, healthcare providers should consider a comprehensive approach that combines cognitive/psychological, self-care behavior management, and education interventions to address the challenges faced by adolescents with type 1 diabetes,” the authors wrote. “Policies should be established to promote non-pharmacological interventions across home, hospital, and school settings, ensuring seamless and privacy-preserving support for adolescents with type 1 diabetes.”
READ MORE: Diabetes Resource Center
References
1. DaeEun L, Haejung L, YoonYoung S, et al. Effectiveness of non-pharmacological interventions for adolescents with type 1 diabetes in the last five years: A systematic review and meta-analysis, Asian Nurs Res, 2024; https://doi.org/10.1016/j.anr.2024.01.008
