August 07, 2019
2 min read

Journaling positively influences glycemic management in pediatric type 1 diabetes

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Itemizing positive aspects of life, or “gratitude journaling,” may help adolescents with type 1 diabetes achieve reduced HbA1c levels, according to findings published in Diabetic Medicine.

“Reviews and meta-analyses of psychosocial interventions for adolescents with type 1 diabetes have demonstrated efficacy in improving psychological well-being, but improvements are often harder to achieve for glycemic control,” Anna Serlachius, PhD, MSc, of the department of psychological medicine at the University of Auckland in New Zealand, and colleagues wrote. “A promising approach may be gratitude interventions.”

Serlachius and colleagues compared HbA1c levels and psychological measures in 60 adolescents with type 1 diabetes in Auckland, New Zealand (mean age, 12.2 years; 53.3% girls), who were randomly assigned to 8 weeks of gratitude journaling or regular care. According to the researchers, gratitude journaling was a daily process in which participants listed three positive aspects of their life.

Participants indicated levels of stress, depression, quality of life, self-care and gratitude in questionnaires at baseline and then at 8 weeks. In addition, at baseline and at 12 weeks, the researchers measured HbA1c levels.

Insulin Adolescent 2019 
Itemizing positive aspects of life, or “gratitude journaling,” may help adolescents with type 1 diabetes achieve reduced HbA1c levels.
Source: Adobe Stock

Although the journaling regimen was meant to be a daily exercise, 55% of participants did not meet this standard. However, multiple weekly but not daily entries were reported by 26% of the participants and weekly entries were recorded by 29%.

After 12 weeks, participants who were assigned to the journaling intervention had a HbA1c level of 8.3% compared with an HbA1c level of 8.9% for those in the standard care group (P = .048), with both groups having a baseline HbA1c measure of 8.4%. The researchers further observed “the more adherent group demonstrating lower HbA1c” compared with those who reported a lower frequency of journaling.

“Changes in HbA1c due to a psychological intervention alone are difficult to achieve and so this pilot study provides a basis for future research into this area,” the researchers wrote. “Developing psychosocial interventions that are feasible and appeal to this population remains an important goal for future research.”

Despite the positive effect that journaling may have had on HbA1c levels, the researchers found that it did not seem to make a difference psychologically, with differences between baseline and 8-week measures of stress, quality of life, self-care, depression and gratitude all failing to reach significance.

“Unexpectedly we did not see any changes in the psychological or behavioral measures, including self-care behaviors or gratitude, which makes it difficult to ascertain that the between-group differences in HbA1c were due to the gratitude intervention,” the researchers wrote. – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.