University of Oulu

Tuomaala A-K, Hero M, Tuomisto MT, Lähteenmäki M, Miettinen PJ, Laine T, Wehkalampi K, Kiiveri S, Ahonen P, Ojaniemi M, Kaunisto K, Tossavainen P, Lapatto R, Sarkola T and Pulkkinen M-A (2021) Motivational Interviewing and Glycemic Control in Adolescents With Poorly Controlled Type 1 Diabetes: A Randomized Controlled Pilot Trial. Front. Endocrinol. 12:639507. doi: 10.3389/fendo.2021.639507

Motivational interviewing and glycemic control in adolescents with poorly controlled type 1 diabetes : a randomized controlled pilot trial

Saved in:
Author: Tuomaala, Anna-Kaisa1; Hero, Matti1; Tuomisto, Martti T.2;
Organizations: 1Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
2Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
3Department of Pediatrics and Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology, Oulu University Hospital and University of Oulu, Oulu, Finland
4Minerva Foundation Institute for Medical Research, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link:
Language: English
Published: Frontiers Media, 2021
Publish Date: 2021-05-18


A multicenter randomized controlled pilot trial investigated whether motivational interviewing (MI) by diabetes physicians improves glycemic control and variability in the context of follow-up for adolescent patients with poorly controlled type 1 diabetes. Patients (n = 47) aged 12 to 15.9 years who showed poor glycemic control (HbA1c >75 mmol/mol/9.0%) were randomized to standard education (SE) only or MI+SE, with study physicians randomized to employ MI+SE (N = 24 patients) or SE only (N = 23). For one year of follow-up, the main outcome measurements were obtained at three-month visits (HbA1c) or six-monthly: time in range (TIR) and glycemic variability (CV). Mean adjusted 12-month change in HbA1c was similar between the MI+SE and SE-only group (-3.6 vs. -1.0 mmol/mol), and no inter-group differences were visible in the mean adjusted 12-month change in TIR (-0.8 vs. 2.6%; P = 0.53) or CV (-0.5 vs. -6.2; P = 0.26). However, the order of entering the study correlated significantly with the 12-month change in HbA1c in the MI+SE group (r = -0.5; P = 0.006) and not in the SE-only group (r = 0.2; P = 0.4). No link was evident between MI and changes in quality of life. The authors conclude that MI’s short-term use by diabetes physicians managing adolescents with poorly controlled type 1 diabetes was not superior to SE alone; however, improved skills in applying the MI method at the outpatient clinic may produce greater benefits in glycemic control.

see all

Series: Frontiers in endocrinology
ISSN: 1664-2392
ISSN-E: 1664-2392
ISSN-L: 1664-2392
Volume: 12
Article number: 639507
DOI: 10.3389/fendo.2021.639507
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: The study was supported by grants from the Finnish Foundation for Pediatric Research, the Diabetes Research Foundation, the Sigrid Juselius Foundation, the Medical Society of Finland, and Helsinki University Hospital Pediatric Research Center.
Copyright information: © 2021 Tuomaala, Hero, Tuomisto, Lähteenmäki, Miettinen, Laine, Wehkalampi, Kiiveri, Ahonen, Ojaniemi, Kaunisto, Tossavainen, Lapatto, Sarkola and Pulkkinen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.