Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland.
Front Endocrinol (Lausanne). 2021 Mar 12;12:639507. doi: 10.3389/fendo.2021.639507. eCollection 2021.
A multicenter randomized controlled pilot trial investigated whether motivational interviewing (MI) by diabetes physicians improves glycemic control and variability in the context of follow-up for adolescent patients with poorly controlled type 1 diabetes. Patients ( = 47) aged 12 to 15.9 years who showed poor glycemic control (HbA1c >75 mmol/mol/9.0%) were randomized to standard education (SE) only or MI+SE, with study physicians randomized to employ MI+SE ( = 24 patients) or SE only ( = 23). For one year of follow-up, the main outcome measurements were obtained at three-month visits (HbA1c) or six-monthly: time in range (TIR) and glycemic variability (CV). Mean adjusted 12-month change in HbA1c was similar between the MI+SE and SE-only group (-3.6 vs. -1.0 mmol/mol), and no inter-group differences were visible in the mean adjusted 12-month change in TIR (-0.8 vs. 2.6%; = 0.53) or CV (-0.5 vs. -6.2; = 0.26). However, the order of entering the study correlated significantly with the 12-month change in HbA1c in the MI+SE group ( = -0.5; = 0.006) and not in the SE-only group ( = 0.2; = 0.4). No link was evident between MI and changes in quality of life. The authors conclude that MI's short-term use by diabetes physicians managing adolescents with poorly controlled type 1 diabetes was not superior to SE alone; however, improved skills in applying the MI method at the outpatient clinic may produce greater benefits in glycemic control.
一项多中心随机对照试验研究了糖尿病医生进行的动机性访谈（MI）是否可以改善青少年 1 型糖尿病控制不佳患者的血糖控制和变异性，作为随访的一部分。12 至 15.9 岁血糖控制不佳（HbA1c>75 mmol/mol/9.0%）的患者被随机分为仅接受标准教育（SE）或 MI+SE，研究医生随机采用 MI+SE（n=24）或仅 SE（n=23）。在为期一年的随访中，主要的测量结果在三个月（HbA1c）或六个月时获得：血糖控制达标时间（TIR）和血糖变异性（CV）。MI+SE 组和 SE 组的平均调整后 12 个月 HbA1c 变化相似（-3.6 与-1.0 mmol/mol），TIR（-0.8 与 2.6%； = 0.53）或 CV（-0.5 与-6.2； = 0.26）的平均调整后 12 个月变化无组间差异。然而，进入研究的顺序与 MI+SE 组的 12 个月 HbA1c 变化显著相关（ =-0.5； = 0.006），而与 SE 组无关（ =0.2； = 0.4）。MI 与生活质量变化之间没有明显联系。作者得出结论，糖尿病医生在管理青少年 1 型糖尿病控制不佳患者时短期使用 MI 并不优于单独的 SE；然而，在门诊中应用 MI 方法的技能提高可能会对血糖控制产生更大的益处。
