Skip to main content
Top
Published in: Current Diabetes Reports 3/2018

01-03-2018 | Therapies and New Technologies in the Treatment of Diabetes (M Pietropaolo, Section Editor)

Family-Based Interventions Targeting Improvements in Health and Family Outcomes of Children and Adolescents with Type 1 Diabetes: a Systematic Review

Authors: Marissa A. Feldman, Lindsay M. Anderson, Jenna B. Shapiro, Aneta M. Jedraszko, Meredyth Evans, Lindsey E. G. Weil, Kimberly P. Garza, Jill Weissberg-Benchell

Published in: Current Diabetes Reports | Issue 3/2018

Login to get access

Abstract

Purpose of Review

A systematic review was conducted of family-based interventions to improve glycemic control, adherence, and psychosocial outcomes in children and adolescents with type 1 diabetes (T1D). Electronic databases were searched for randomized controlled trials (RCTs) published since the seminal Diabetes Control and Compliance Trial (DCCT). Interventions are summarized and findings reviewed to help guide clinical practice and future research.

Recent Findings

Twenty-five RCTs are reviewed. The majority of studies (n = 15) focused on interventions targeting both children and adolescents and their caregivers and were delivered in diabetes clinics, outpatient settings, mental health clinics, or participants’ homes.

Summary

Family-based interventions for youth with T1D appear effective at improving diabetes and family-centered outcomes. Additional research is needed to examine the pathways to improvement in glycemic control, as outcomes were mixed. Future research should also involve measures beyond HbA1c given new markers for sustained health improvement and outcomes are being explored.
Appendix
Available only for authorised users
Literature
1.
go back to reference Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulindependent diabetes mellitus. J Pediatr. 1994;125:177–88.CrossRef Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulindependent diabetes mellitus. J Pediatr. 1994;125:177–88.CrossRef
2.
go back to reference Tamborlane WV, Gatcomb P, Held N, Ahern J. Implications of the DCCT results in treating children and adolescents with diabetes. Clinical. Diabetes. 1994;12(5):115–7. Tamborlane WV, Gatcomb P, Held N, Ahern J. Implications of the DCCT results in treating children and adolescents with diabetes. Clinical. Diabetes. 1994;12(5):115–7.
5.
go back to reference • Wiebe DJ, Chow CM, Palmer DL, Butner J, Butler JM, Osborn P, et al. Developmental processes associated with longitudinal declines in parental responsibility and adherence to type 1 diabetes management across adolescence. J Pediatr Psychol. 2014;39(5):532–41. Demonstrated that declines in adherence during adolescence may be mitigated by matching decline in parental responsibility with increasing self-efficacy CrossRefPubMedPubMedCentral • Wiebe DJ, Chow CM, Palmer DL, Butner J, Butler JM, Osborn P, et al. Developmental processes associated with longitudinal declines in parental responsibility and adherence to type 1 diabetes management across adolescence. J Pediatr Psychol. 2014;39(5):532–41. Demonstrated that declines in adherence during adolescence may be mitigated by matching decline in parental responsibility with increasing self-efficacy CrossRefPubMedPubMedCentral
6.
go back to reference • Chiang JL, Kirkman MS, Laffel LM, Peters AL. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes Care. 2014;37(7):2034–54. Summarizes data to provide guidance regarding the identification and treatment of T1D across the developmental lifespan. https://doi.org/10.2337/dc14-1140.CrossRefPubMed • Chiang JL, Kirkman MS, Laffel LM, Peters AL. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes Care. 2014;37(7):2034–54. Summarizes data to provide guidance regarding the identification and treatment of T1D across the developmental lifespan. https://​doi.​org/​10.​2337/​dc14-1140.CrossRefPubMed
13.
go back to reference • Hilliard ME, Powell PW, Anderson BJ. Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. Am Psychol. 2016;71(7):590. Review of evidence-based behavioral interventions and an explanation of guiding behavioral principles that inform interventions for T1D and T2D–601. https://doi.org/10.1037/a0040359.CrossRefPubMedPubMedCentral • Hilliard ME, Powell PW, Anderson BJ. Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. Am Psychol. 2016;71(7):590. Review of evidence-based behavioral interventions and an explanation of guiding behavioral principles that inform interventions for T1D and T2D601. https://​doi.​org/​10.​1037/​a0040359.CrossRefPubMedPubMedCentral
34.
go back to reference Ellis DA, Frey MA, Naar-King S, Templin T, Cunningham PB, Cakan N. The effects of multisystemic therapy on diabetes stress among adolescents with chronically poorly controlled type 1 diabetes: findings from a randomized, controlled trial. Pediatrics. 2005;116(6):e826-e32.CrossRef Ellis DA, Frey MA, Naar-King S, Templin T, Cunningham PB, Cakan N. The effects of multisystemic therapy on diabetes stress among adolescents with chronically poorly controlled type 1 diabetes: findings from a randomized, controlled trial. Pediatrics. 2005;116(6):e826-e32.CrossRef
44.
go back to reference • Holmes CS, Chen R, Mackey E, Grey M, Streisand R. Randomized clinical trial of clinic-integrated, low-intensity treatment to prevent deterioration of disease care in adolescents with type 1 diabetes. Diabetes Care. 2014;37(6):1535–43. RCT examining a brief behavioral intervention for adolescents and their parents to prevent expected decline in adherence and control typically seen during adolesence. https://doi.org/10.2337/dc13-1053.CrossRefPubMedPubMedCentral • Holmes CS, Chen R, Mackey E, Grey M, Streisand R. Randomized clinical trial of clinic-integrated, low-intensity treatment to prevent deterioration of disease care in adolescents with type 1 diabetes. Diabetes Care. 2014;37(6):1535–43. RCT examining a brief behavioral intervention for adolescents and their parents to prevent expected decline in adherence and control typically seen during adolesence. https://​doi.​org/​10.​2337/​dc13-1053.CrossRefPubMedPubMedCentral
48.
go back to reference Westrupp EM, Northam E, Lee KJ, Scratch SE, Cameron F. Reducing and preventing internalizing and externalizing behavior problems in children with type 1 diabetes: a randomized controlled trial of the Triple P-Positive Parenting Program. Pediatr Diabetes. 2015;16(7):554–63. https://doi.org/10.1111/pedi.12205.CrossRefPubMed Westrupp EM, Northam E, Lee KJ, Scratch SE, Cameron F. Reducing and preventing internalizing and externalizing behavior problems in children with type 1 diabetes: a randomized controlled trial of the Triple P-Positive Parenting Program. Pediatr Diabetes. 2015;16(7):554–63. https://​doi.​org/​10.​1111/​pedi.​12205.CrossRefPubMed
55.
go back to reference Ellis DA, Naar-King S, Templin T, Frey MA, Cunningham PB. Improving health outcomes among youth with poorly controlled type I diabetes: the role of treatment fidelity in a randomized clinical trial of multisystemic therapy. J Fam. 2007;21(3):363. Ellis DA, Naar-King S, Templin T, Frey MA, Cunningham PB. Improving health outcomes among youth with poorly controlled type I diabetes: the role of treatment fidelity in a randomized clinical trial of multisystemic therapy. J Fam. 2007;21(3):363.
56.
go back to reference • Wright LA-C, Hirsch IB. Metrics beyond hemoglobin A1c in diabetes management: time in range, hypoglycemia, and other parameters. Diabetes Technol Ther. 2017;19(S2):S-16–26. Provides the latest examination of biomarkers for measuring individual blood glucose control, encouraging investigation and clinical utility beyond sole use of HbA1c. https://doi.org/10.1089/dia.2017.0029.CrossRef • Wright LA-C, Hirsch IB. Metrics beyond hemoglobin A1c in diabetes management: time in range, hypoglycemia, and other parameters. Diabetes Technol Ther. 2017;19(S2):S-16–26. Provides the latest examination of biomarkers for measuring individual blood glucose control, encouraging investigation and clinical utility beyond sole use of HbA1c. https://​doi.​org/​10.​1089/​dia.​2017.​0029.CrossRef
Metadata
Title
Family-Based Interventions Targeting Improvements in Health and Family Outcomes of Children and Adolescents with Type 1 Diabetes: a Systematic Review
Authors
Marissa A. Feldman
Lindsay M. Anderson
Jenna B. Shapiro
Aneta M. Jedraszko
Meredyth Evans
Lindsey E. G. Weil
Kimberly P. Garza
Jill Weissberg-Benchell
Publication date
01-03-2018
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 3/2018
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-018-0981-9

Other articles of this Issue 3/2018

Current Diabetes Reports 3/2018 Go to the issue

Health Care Delivery Systems and Implementation in Diabetes (ME McDonnell and AR Sadhu, Section Editors)

Common Models Used for Inpatient Diabetes Management

Microvascular Complications—Nephropathy (M Afkarian and B Roshanravan, Section Editors)

The Landscape of Diabetic Kidney Disease in the United States

Microvascular Complications—Nephropathy (M Afkarian and B Roshanravan, Section Editors)

Diabetic Kidney Disease: Is There a Role for Glycemic Variability?

Diabetes and Pregnancy (M-F Hivert and CE Powe, Section Editors)

Clinical Management of Women with Monogenic Diabetes During Pregnancy

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.