School of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Diabetes Care. 2010 Mar;33(3):602-4. doi: 10.2337/dc09-1881. Epub 2009 Dec 23.
OBJECTIVE To report results from YourWay, an Internet-based self-management intervention for adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS A total of 72 adolescents with type 1 diabetes, ages 13-17 years, were randomized to a usual-care-plus-Internet support or a usual-care group. The intervention was designed to enhance problem-solving barriers to self-management. A1C was obtained from medical records, and problem-solving and self-management were obtained via adolescent report. RESULTS Group differences were not statistically significant using intent-to-treat analyses. Using as-treated analyses, adolescents in the treatment condition showed statistically significant improvement in self-management (d = 0.64; P = 0.02) and important improvements in problem-solving (d = 0.30; P = 0.23) and A1C (d = -0.28; P = 0.27). Mean A1C for the intervention group remained constant (-0.01%), while the control group increased (0.33%). CONCLUSIONS This brief trial suggests that self-management support delivered through a secure website may improve self-management and offset typical decreases in adolescent glycemic control.
报告基于互联网的青少年 1 型糖尿病自我管理干预措施 YourWay 的研究结果。
共有 72 名年龄在 13-17 岁的 1 型糖尿病青少年被随机分为常规治疗加互联网支持组或常规治疗组。该干预措施旨在增强自我管理的问题解决障碍。A1C 数据从病历中获取，问题解决和自我管理情况通过青少年报告获得。
意向治疗分析显示两组间差异无统计学意义。采用治疗分析，治疗组青少年的自我管理（d = 0.64；P = 0.02）和问题解决（d = 0.30；P = 0.23）显著改善，A1C（d = -0.28；P = 0.27）也有重要改善。干预组的平均 A1C 保持不变（-0.01%），而对照组则增加（0.33%）。
这项简短的试验表明，通过安全网站提供的自我管理支持可能会改善自我管理，并抵消青少年血糖控制的典型下降。
