Journal
DIABETES CARE
Volume 31, Issue 9, Pages 1746-1747Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc07-2094
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Funding
- National Institute of Diabetes and Digestive and Kidney Diseases [R01 DK59067]
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OBJECTIVE - The Study aim was to determine if multisystemic therapy (MST), an intensive home-based psychotherapy, could reduce hospital admissions for diabetic ketoacidosis (DKA) in youth with poorly controlled type 1 diabetes over 24 months. Potential cost savings from reductions in admissions were also evaluated. RESEARCH DESIGN AND METHODS - A total of 127 youth were randomly assigned to MST or control groups and also received standard medical care. RESULTS - Youth who received MST had significantly fewer hospital admissions than control subjects (chi(2) = 11.77, 4 d.f., n = 127; P = 0.019). MST-treated youth had significantly fewer admissions versus their baseline rate at 6-month (P = 0.004), 12-month (P = 0.021), 18-month (P = 0.046), and 24-month follow-up (P = 0.034). Cost to provide MST was 6,934 USD per youth; however, substantial cost offsets occurred from reductions in DKA admissions. CONCLUSIONS - The study demonstrates the value of intensive behavioral interventions for high-risk youth with diabetes for reducing one of the most serious consequences of medication noncompliance.
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