Endocrinology, diabetes & metabolism · 2026
Preliminary Outcomes of a Brief Values-Guided Self-Management Intervention to Improve Glucose Levels Among Emerging Adults With Type 1 Diabetes and Above-Recommended HbA1c: A Pilot Study.
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Styles Sara E, Haszard Jillian J, Oravcova-Wheeler Zuzana, Campbell Anna, Arroll Bruce, Ciarrochi Joseph, Hayes Louise, Lemon Jim, Ketu-McKenzie Miriama, Wheeler Benjamin J
Аннотация
INTRODUCTION: A minority of young adults with type 1 diabetes achieve > 70% time in range (TIR; 70-180 mg/dL [3.9-10 mmol/L]), as recommended. Self-management goals based on self-chosen values (whatever is most important to an individual) may motivate engagement in self-management tasks that could improve TIR. This study explored the acceptability, feasibility, and potential outcomes of values-guided self-management.
METHODS: A single-arm quasi-experimental pilot study was conducted with 14 participants aged 18-25 years and HbA1c ≥ 58 mmol/mol (7.5%). The intervention consisted of a single 1:1 session (< 60 min) grounded in Acceptance and Commitment Therapy and a 2-week follow-up. The session consisted of a semi-structured discussion of self-management behaviour, behavioural alignment with personally chosen values, barriers to behaviour change, and action planning. TIR was determined by glucose levels measured with a blinded interstitial continuous glucose monitoring sensor. Participants self-reported adherence to self-management tasks, psychological flexibility, valued living and acceptance of living with diabetes.
RESULTS: Fourteen participants received the intervention. The intervention was acceptable and feasible to implement. The mean change (95% CI) between pre- and post-intervention TIR was an increase of 2.2 (-1.2, 5.7) percentage points, mostly through a decrease in time above range. The standardized mean change (95% CI) in progress towards valued living was 0.72 (0.27, 1.16) with small improvements in diabetes-specific acceptance and carrying out valued actions.
CONCLUSIONS: A brief values-guided self-management intervention shows promise to improve time in range among emerging adults with type 1 diabetes and above recommended HbA1c. Further investigation of values-guided self-management is warranted.
TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12620000200987; https://www.anzctr.org.au/ACTRN12620000200987.aspx).
METHODS: A single-arm quasi-experimental pilot study was conducted with 14 participants aged 18-25 years and HbA1c ≥ 58 mmol/mol (7.5%). The intervention consisted of a single 1:1 session (< 60 min) grounded in Acceptance and Commitment Therapy and a 2-week follow-up. The session consisted of a semi-structured discussion of self-management behaviour, behavioural alignment with personally chosen values, barriers to behaviour change, and action planning. TIR was determined by glucose levels measured with a blinded interstitial continuous glucose monitoring sensor. Participants self-reported adherence to self-management tasks, psychological flexibility, valued living and acceptance of living with diabetes.
RESULTS: Fourteen participants received the intervention. The intervention was acceptable and feasible to implement. The mean change (95% CI) between pre- and post-intervention TIR was an increase of 2.2 (-1.2, 5.7) percentage points, mostly through a decrease in time above range. The standardized mean change (95% CI) in progress towards valued living was 0.72 (0.27, 1.16) with small improvements in diabetes-specific acceptance and carrying out valued actions.
CONCLUSIONS: A brief values-guided self-management intervention shows promise to improve time in range among emerging adults with type 1 diabetes and above recommended HbA1c. Further investigation of values-guided self-management is warranted.
TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12620000200987; https://www.anzctr.org.au/ACTRN12620000200987.aspx).