Diabetes, Nutrition, Obesity and Eating Disorders

Adults living with type 1 diabetes (T1D) can find the condition challenging to manage, resulting in many struggling with suboptimal glycaemic control, and thus increasing their risk of acute and long-term health problems. Psychological distress can present additional barriers to improving self-care. Standard diabetes care includes medical, educational and technological interventions, which are important however, for a significant proportion of patients, these may not be sufficient. We describe a brief multi-component behavioural intervention based on well-established principles of complex learning and behaviour. The intervention aims to increase frequency of valued self-care activities and reduce avoidance coping. The Enhanced Self-Care for Diabetes (ESD) intervention components can be presented in either individual or group format. ESD is personalized to each individual’s diabetes self-care goals, self-management skills and current circumstances. Program components are pragmatic and straightforward by design so that the individuals can self-manage behaviour change for longer-term benefit. We present group evaluation data with n=66 participants attending our outpatient tertiary diabetes centre. Evaluation measures include glycaemic control, frequency of diabetes self-care activities, diabetes-related distress, hypoglycemia worry, diabetes-related eating problems, and quality of life. Participant satisfaction with treatment outcomes and acceptability of the methods used to address diabetes-related concerns will be presented. Characteristics of the program completers and non-completers, and potential mediators and moderators of intervention outcomes will be discussed. Illustrative examples will be used to highlight the reasons underlying diabetes-related distress, and how facilitating incremental increases in key self-care behaviours can lead to improving clinical outcomes in a high-risk population with diabetes.