Diabetes Care：网络教程改善青少年糖尿病预后

　　一项新的研究表明，参加网络心理教育项目可改善青少年1型糖尿病患者预后。两项网络教育计划都参与的青少年预后优于仅参加其中一项者。研究提示青少年患者既需要血糖管理方面的教育，又需要行为干预方面的指导。 

与糖尿病相关的拓展阅读：

• 孕中期空腹血糖适合筛查我国妊娠期糖尿病
• 自体荧光测糖尿病微血管病变
• Diabetes Care：青少年肥胖者发生糖尿病风险高于成人
• Hypertension：无糖尿病患者ACEI与小剂量噻嗪利尿剂联用对胰岛素作用影响不大
• Nat Rev Cardiol：戒烟降低非糖尿病患者心血管疾病风险 更多信息请点击：有关糖尿病更多资讯

Internet Psycho-Education Programs Improve Outcomes in for Youth With Type 1 Diabetes
OBJECTIVE
The purpose of this study was to determine the efficacy of two internet-based psycho-educational programs designed to improve outcomes for youth with type 1 diabetes transitioning to adolescence.
RESEARCH DESIGN AND METHODS
The study was a multisite clinical trial of 320 youth (age 11–14 years; 37% minority; 55% female) randomized to one of two internet-based interventions: TeenCope or Managing Diabetes. Primary outcomes were HbA1c and quality of life (QOL). Secondary outcomes included coping, self-efficacy, social competence, self-management, and family conflict. Data were collected at baseline and after 3, 6, and 12 months online. Youth were invited to cross over to the other program after 12 months, and follow-up data were collected at 18 months. Analyses were based on mixed models using intent-to-treat and per-protocol procedures.
RESULTS
Youth in both groups had stable QOL and minimal increases in HbA1c levels over 12 months, but there were no significant differences between the groups in primary outcomes. After 18 months, youth who completed both programs had lower HbA1c (P = 0.04); higher QOL (P = 0.02), social acceptance (P = 0.01), and self-efficacy (P = 0.03) and lower perceived stress (P = 0.02) and diabetes family conflict (P = 0.02) compared with those who completed only one program.
CONCLUSIONS
Internet interventions for youth with type 1 diabetes transitioning to adolescence result in improved outcomes, but completion of both programs was better than only one, suggesting that these youth need both diabetes management education and behavioral interventions. Delivering these programs via the internet represents an efficient way to reach youth and improve outcomes.