AIM: To investigate whether assigning young, healthy and motivated lay volunteer partners("buddies") to adolescents with type 2 diabetes improves hemoglobin A1c(HbA 1c). METHODS: Adolescents with type 2 diab...AIM: To investigate whether assigning young, healthy and motivated lay volunteer partners("buddies") to adolescents with type 2 diabetes improves hemoglobin A1c(HbA 1c). METHODS: Adolescents with type 2 diabetes were randomized to partnering with a "buddy" or to conventional treatment. During the initial screening visit, which coincided with a routine outpatient diabetes clinic visit, patients with type 2 diabetes underwent a physical examination, detailed medical history, laboratory measurement of HbA 1c, and completed two questionnaires(Pediatric Quality of Life Inventory and Children's Depression Inventory) to assess their overall quality of life and the presence of depressive symptoms. Patients were then randomized to the intervention(the buddy system) or conventional treatment(standard care). All patients were scheduled to return for followup at 3- and 6-mo after their initial visit. Hb A1 c was determined at all visits(i.e., at screening and at the 3- and 6-mo follow-up visits) and quality of life and depressive symptoms were evaluated at the screening visit and were reassessed at the 6-mo visit. RESULTS: Ten adolescents, recruited from a pool of approximately 200 adolescents, enrolled over a twoyear time period, leading to premature termination of the study. In contrast, we easily recruited motivated lay volunteers. We found no change in HbA 1c from the initial to the 6-mo visit in either group, yet our small sample size limited systematic assessment of this outcome. Participants repeatedly missed clinic appointments, failed to conduct self-glucose-monitoring and rarely brought their glucometers to clinic visits. Total quality of life scores(72.6 ± 6.06) at screening were similar to previously reported scores in adolescents with type 2 diabetes(75.7 ± 15.0) and lower than scores reported in normal-weight(81.2 ± 0.9), overweight(83.5 ± 1.8), and obese youths without diabetes(78.5 ± 1.8) or in adolescents with type 1 diabetes(80.5 ± 13.1). Among adolescents who returned for their 6-mo visit, there were no differences in total quality of life scores(70.2 ± 9.18) between screening and follow-up.CONCLUSION: Our approach, effective in adults with type 2 diabetes, was unsuccessful among adolescents and emphasizes the need for innovative strategies for diabetes treatment in adolescent patients.展开更多
基金Supported by The Intramural Research Program of the National Institutes of Healththe National Institute of Diabetes,Digestive+2 种基金Kidney Diseases in collaboration with the Division of EndocrinologyDiabetes at the Children’s National Medical Center(Washington,DC)provided by the Endocrine Fellows Foundation Marilyn Fishman Grant for Diabetes Research
文摘AIM: To investigate whether assigning young, healthy and motivated lay volunteer partners("buddies") to adolescents with type 2 diabetes improves hemoglobin A1c(HbA 1c). METHODS: Adolescents with type 2 diabetes were randomized to partnering with a "buddy" or to conventional treatment. During the initial screening visit, which coincided with a routine outpatient diabetes clinic visit, patients with type 2 diabetes underwent a physical examination, detailed medical history, laboratory measurement of HbA 1c, and completed two questionnaires(Pediatric Quality of Life Inventory and Children's Depression Inventory) to assess their overall quality of life and the presence of depressive symptoms. Patients were then randomized to the intervention(the buddy system) or conventional treatment(standard care). All patients were scheduled to return for followup at 3- and 6-mo after their initial visit. Hb A1 c was determined at all visits(i.e., at screening and at the 3- and 6-mo follow-up visits) and quality of life and depressive symptoms were evaluated at the screening visit and were reassessed at the 6-mo visit. RESULTS: Ten adolescents, recruited from a pool of approximately 200 adolescents, enrolled over a twoyear time period, leading to premature termination of the study. In contrast, we easily recruited motivated lay volunteers. We found no change in HbA 1c from the initial to the 6-mo visit in either group, yet our small sample size limited systematic assessment of this outcome. Participants repeatedly missed clinic appointments, failed to conduct self-glucose-monitoring and rarely brought their glucometers to clinic visits. Total quality of life scores(72.6 ± 6.06) at screening were similar to previously reported scores in adolescents with type 2 diabetes(75.7 ± 15.0) and lower than scores reported in normal-weight(81.2 ± 0.9), overweight(83.5 ± 1.8), and obese youths without diabetes(78.5 ± 1.8) or in adolescents with type 1 diabetes(80.5 ± 13.1). Among adolescents who returned for their 6-mo visit, there were no differences in total quality of life scores(70.2 ± 9.18) between screening and follow-up.CONCLUSION: Our approach, effective in adults with type 2 diabetes, was unsuccessful among adolescents and emphasizes the need for innovative strategies for diabetes treatment in adolescent patients.
