OBJECTIVE -We sought to examine the efficacy of motivational interviewing with teenagers aged 14 -17 years with type 1 diabetes.RESEARCH DESIGN AND METHODS -In a randomized controlled trial analyzed by intention to treat, 66 teenagers with type 1 diabetes attending diabetes clinics in South Wales, U.K., were randomly assigned to the intervention group (38) and control group (28). Teenagers in the intervention group received motivational interviewing, and the control group received support visits. All participants received individual sessions over 12 months. The main outcome measures assessed at baseline, 6, 12, and 24 months were serum A1C and psychosocial selfreport questionnaires including quality of life and well-being measures.RESULTS -At 12 months, 60 patients had complete data. At the end of the intervention (12 months), the mean A1C in the motivational interviewing group was significantly lower than in the control group (P ϭ 0.04), after adjusting for baseline values. At 24 months (when n ϭ 47), this difference in A1C was maintained (P ϭ 0.003). There were differences in psychosocial variables at 12 months, with the motivational interviewing group indicating more positive well-being, improved quality of life, and differences in their personal models of illness (all P Ͻ 0.01). Some of these differences were maintained at 24 months.CONCLUSIONS -Motivational interviewing can be an effective method of facilitating behavioral changes in teenagers with type 1 diabetes with subsequent improvement in their glycemic control.

Aims: To obtain preliminary data on the impact of motivational interviewing, a counselling approach to behaviour change, on glycaemic control, wellbeing, and self-care of adolescents with diabetes. Methods: Twenty two patients aged 14-18 years participated in motivational interviewing sessions during a six month intervention. The effects of the intervention on HbA1c and a range of psychological factors were assessed. Results: Mean HbA1c decreased from 10.8% to 9.7% during the study and remained significantly lower after the end of the study. Fear of hypoglycaemia was reduced and diabetes was perceived as easier to live with. There were no other significant changes in the psychological measures. By contrast no reduction in HbA1c values was observed in a comparison group who did not receive the motivational interviewing intervention. Conclusion: The findings of this pilot study indicate that motivational interviewing may be a useful intervention in helping adolescents improve their glycaemic control. A larger, longer term randomised controlled study is indicated to clarify the mechanisms and extent of these benefits.

There is a clear need to develop service structures that recognize the continuing role played by mothers in the diabetes care of young adults.

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Focusing on continuity mechanisms, their inter-relations and the effectiveness of different constellations of service components in achieving smooth transition has furnished evidence to inform the development of innovative models which build on the logic of these findings but are sensitive to local context. Further studies are needed to confirm the quantitative findings from a broader range of services and patients.