Effect of Diabetes Self-Management Education (DSME) with and without Motivational Interviewing (MI) on Glycemic Control among Children and Adolescents with Type 1 Diabetes Mellitus: A Randomized Controlled Trial

Ornsuda  Lertbannaphong; Pimonsri  Hantanasiriskul; Pornpimol  Kiattisakthavee; Sunsanee  Ruangson; Nantawat  Sitdhiraksa; Jeerunda  Santiprabhob

doi:10.33192/Smj.2021.82

Authors

Ornsuda Lertbannaphong Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Pimonsri Hantanasiriskul Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Pornpimol Kiattisakthavee Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Sunsanee Ruangson Department of Pediatrics, Nakhonpathom Hospital, Nakhonpathom
Nantawat Sitdhiraksa Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Jeerunda Santiprabhob Siriraj Diabetes Center of Excellence. Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok

DOI:

https://doi.org/10.33192/Smj.2021.82

Keywords:

T1dm, Motivational Interviewing Diabetes, Self-Management Education, Glycemic Control

Abstract

Background: Type 1 diabetes mellitus (T1DM) is a chronic disease that is difficult to control. Motivational interviewing (MI) is a collaborative style of communication that was designed to strengthen a person’s motivation and commitment to change and improve. We hypothesized that applying MI to diabetes care would lead to improved glycemic control and improved diabetes self-care behavior.

Methods: Subjects were T1DM patients aged 10-18 years with HbA_1C ≥8% that were recruited from the Outpatient Diabetes Clinic during October 2016 - March 2017. Subjects were randomized into the diabetes self-management education (DSME) or DSME plus MI groups. HbA_1C levels, diabetes knowledge test, and diabetes self-care behavioral questionnaire were performed.

Results: Thirty-five patients (17 DSME, 18 DSME + MI) completed the study. Baseline HbA_1C was not significantly different between groups. At the end of the study, HbA_1C levels were not significantly different within or between groups. From pre-intervention to post-intervention, diabetes knowledge scores were significantly increased, and self-care behavioral scores were significantly increased for dietary control and medical taking. Transition to the stages of change action stage was increased from 0 to 12 persons.

Conclusions: The effectiveness of MI on glycemic control was not found to be statistically significant at 6 months. However, continuation of DSME in T1DM patients is necessary for improving diabetes knowledge and care. Further study in a larger sample size with longer duration of MI and follow-up is needed to conclusively establish the value of MI on glycemic control in pediatric T1DM.

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