ESPE Abstracts (2016) 86 RFC5.8

Stress Management and Health Promotion through Family Intervention Improves Metabolic Control in Children and Adolescents with Type 1 Diabetes

Laura Panayia, Christina Kanaka-Gantenbeinb, Christina Darviric & George P. Chrousosd


aSchool of Medicine, National and Kapodistrian University of Athens, Athens, Greece; bDiabetes Center, Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, Children’s Hospital Aghia Sophia, School of Medicine, National and Kapodistrian University of Athen, Athens, Greece; cSchool of Medicine, National and Kapodistrian University of Athens, Athens, Greece; dFirst Department of Pediatrics, Children’s Hospital Aghia Sophia, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece


Background: Optimal glycemic control in children and adolescents with type 1 diabetes mellitus (T1DM) is often hampered owing to psychologic maladjustment of both patients and their parents. Accumulating evidence suggests that hyperglycemia may be associated with prolonged activation of the stress system.

Objective and hypotheses: To pilot test a 12-week intervention program including psychoeducation about stress, healthy lifestyle, diaphragmatic breathing, progressive muscle relaxation, guided imagery, cognitive restructuring, gratitude and health locus of control in children and adolescents with T1DM and their parents. We hypothesized that patients of the intervention group would have lower HbA1c levels and lower anxiety and depressive symptomatology than controls after the intervention. We also hypothesized that parents of the intervention group would have lower perceived stress, anxiety and depressive symptoms and a significant change in health beliefs than the control group.

Method: Thirty-two patient-parent dyads were randomly assigned to the intervention (n=17) and control (n=15) group. HbA1c of the patients of both groups was recorded before and after the intervention. Moreover, patients completed the Screen for Child Anxiety Related Disorders and the Child Depression Inventory; the participating parent completed the Perceived Stress Scale, the Depression Anxiety Stress Scale and the Health Locus of Control Scale.

Results: A significant reduction in HbA1c was observed in children and adolescents of the intervention group compared to controls (ΔHbA1c=−0.34±0.23 vs +0.61±0.45 (P<0.014)). Moreover, a trend toward decreased perceived stress in sparents of the intervention group was detected. Paradoxically, the external health locus of control significantly decreased only in the parents of the control group.

Conclusion: A family-based intervention of stress management and health promotion could facilitate metabolic control in Greek children and adolescents with T1DM. Further studies in a larger sample are required to confirm the effectiveness of such an intervention within this population.

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