Diabetes coaching sparks HbA1c progress in pediatric type 1 diabetes
SAN FRANCISCO — Providing consistent diabetes care coaching over the phone in combination with an incentive program was shown to lower HbA1c levels in children with type 1 diabetes, according to findings presented at the American Diabetes Association 79th Scientific Sessions.
“The ideal way to do this is to have coaching for all patients, especially those at higher risk,” Fran R. Cogen, MD, director of the childhood and adolescent diabetes program at Children’s National Health System in Washington, D.C., told Endocrine Today. “This is very labor intensive, so you need a lot of time from different coaches. We are trying to get out of the office-centric model to where we’re in the community and at home.”
Cogen and colleagues at the Children’s National Health System recruited 25 children with type 1 diabetes (mean age, 11.6 years) and their families for a pilot study examining the effects of a 10-week coaching program on HbA1c levels. The average HbA1c level in the cohort was 9.4% at baseline. In addition to the coaching, an incentive to meet HbA1c goals was included in which the participants were given the chance to win an iPad.
“The kids were very excited at the possibility of winning an iPad, and I think that did contribute to sort of a competition, and as we know, competitions work well, at least in the short term,” Cogen said, while admitting that the data were too limited to indicate whether coaching or the incentive was more effective in driving HbA1c goal attainment. “I’m not sure how that would be sustained in the future.”
After 10 weeks of coaching, HbA1c levels were lower for 20 of the 25 participants, with these participants averaging a reduction of 0.5%. The researchers further noted that HbA1c declines of more than 0.5% and more than 1% were achieved by 17 and seven of the participants, respectively.
“You develop a relationship with your diabetes team either by phone or email, and then ... each time the provider or team member speaks to the family, they don’t have to start from A,” Cogen said. “They’re already involved. They already know the patient, and you get more efficient in delivering advice.” – by Phil Neuffer
Clary LE, et al. 1260-P. A clinical care improvement pilot program: Individualized health coaching and use of incentives for youth with type 1 diabetes and their caregivers. Presented at: American Diabetes Association 79th Scientific Sessions; June 7-11, 2019; San Francisco.
Disclosure: Cogen reports no relevant financial disclosures.