Results indicate improvements in mental and physical health as well as reduced healthcare costs for people with type 1 diabetes
SAN DIEGO, June 24, 2023 /PRNewswire/ — The results of two studies evaluating the impact of mental health support for patients with diabetes found significant benefits on patient outcomes were presented today at the 83rd American Diabetes Association Scientific Sessions® (ADA) in San Diego, California.
As the number of diabetes cases continues to rise, addressing mental health issues is an essential part of helping people with diabetes manage their care plan. Diabetes distress (DD), for example, includes the fears, worries, and burdens associated with the diabetes experience. DD, distinct from depression, is common in adults with type 1 diabetes (T1D). In fact, in any 18 month period, 33% to 50% of people with diabetes have high levels of DD. People with diabetes are also 2-3 times more likely to suffer from depression than people without diabetes. Besides, only 25% to 50% of people with diabetes suffering from depression are diagnosed and treated. This underscores the need to provide proactive behavioral health support as part of the overall plan of care.
“People with type 1 diabetes are at increased risk for mental health problems, including diabetes distress, depression, anxiety, and eating disorders. However, these are all treatable conditions that can be treated with personalized treatment plans that go beyond the physical symptoms,” said Robert Gabby, MD, PhD, scientific and medical director of the ADA. “I am encouraged by the results of the studies presented at this year’s scientific sessions, as we continue to search for innovative, evidence-based solutions that support people with diabetes when they need it most.”
EMBARK Clinical Trial: Reducing the Emotional Loads of Living with Diabetes
Results from the EMBARK randomized controlled clinical trial revealed significant reductions in DD in adults with T1D using three intervention programs.
The EMBARK trial included 300 adults with T1D and high distress. Individuals were randomly assigned to receive one of three intervention programs: (1) Streamline, an educator-led education and management program; (2) TunedIn, a psychologist-led program focused exclusively on reducing diabetes-related distress; or (3) FixIt, an integration of the StreamLine and TunedIn programs. Each intervention was delivered in a virtual group format over a period of three to four months, including initial workshops, one-on-one phone calls, and follow-up meetings.
The results demonstrated a large and clinically meaningful reduction in DD in all three arms of the study at follow-up assessment, with 35% of participants no longer reporting high levels of distress at follow-up and 74% of participants reporting reported a clinically important reduction in distress. . The FixIt intervention, which integrated DD-targeted educational and emotional approaches, resulted in the greatest reduction in DD, followed by TunedIn and Streamline. DD reductions were significantly greater in the FixIt intervention compared to Streamline.
“Preliminary results from the EMBARK trial are promising for people living with T1D who experience diabetes-related distress,” said Danielle HesslerJonesPhD, Professor and Vice Director of Research in the University’s Department of Family and Community Medicine University of California, San Francisco, and lead investigator. “These findings underscore the importance of providing comprehensive support that meets both the educational and emotional needs of people with diabetes.”
The authors of this study will report 12-month follow-up results later this year to understand whether these improvements were maintained alongside blood sugar results. Additionally, there are plans to expand this work into DD-ASSIST, a new study in which researchers will train clinical teams from 18 diabetes clinics on how to assess and treat DD as part of their delivery of care.
Last Minute Poster: Do The Right Thing: Behavioral Intervention for At-Risk Youth with T1D
Results from the study evaluating the home and community behavioral health intervention for young people with diabetes, New Interventions in Health Care for Children (NICH), found that in addition to better health , patients had lower health care costs in the years after starting NICH.
The study assessed direct cost data from three health systems provided to youth with preventable health conditions who received an intensive NICH behavioral health intervention. Young people were included in the analyzes if they had T1D and at least one year of cost data before and after NICH enrollment. Outpatient, emergency department and inpatient costs were combined, with variability in the amount and type of cost data present from site to site.
The analysis focused on 53 young people: mean age 14.2 ± 2.4 years; 87% Medicaid; 58% women, 42% men; 32% Black, 29% Non-Hispanic White, 28% Hispanic/Latinx, 7% Pacific Islander, 2% Asian, and 2% other racial and ethnic groups. The average annual direct costs were $58,100 And $21,800, before and after NICH enrollment, respectively, but not significantly different. After removing three outliers (>3 SD from the mean), the average annual costs decreased significantly by $20,400 For $9.5,000 per young person, mainly due to hospitalization costs.
“These results highlight the benefits of providing access to intensive interventions for pediatric populations facing health disparities,” said David V. Wagner, PhD and lead author. “Investing early in life in young people struggling with health disparities is not only the right thing to do to improve patient health, but it could also have a positive economic impact down the road.”
Researchers are designing follow-up studies and related efforts to further expand access to this intervention nationwide and determine the impact on the lived experience of people with diabetes.
Details of the research presentation:
Dr. Hessler will present the results in the following oral presentation session:
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ADA Chairs’ Selection Summary: EMBARK – A Randomized, Controlled Trial Comparing Three Approaches to Reduce Diabetes-Related Distress in Adults With Type 1 Diabetes
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Presented on Saturday, June 24, 2023 To 4:30 p.m. PST
Dr. Wagner will present the results in the following general poster session:
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Doing the Right Thing – Intensive Intervention and Consequent Costs for Young People at High Social Risk and with Type 1 Diabetes (T1D)
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Presented on Saturday, June 24, 2023 To 11:30 a.m. PST
About ADA Scientific Sessions
The 83s of the ADArd The Scientific Sessions, the world’s largest scientific meeting focused on diabetes research, prevention and care, will be held at San Diego, California June 23-26. More than 12,000 leading doctors, scientists and healthcare professionals from around the world are expected to come together in person and virtually to unveil cutting-edge research, treatment recommendations and advances towards a cure for diabetes. Participants will receive exclusive access to thousands of original research presentations and take part in provocative and engaging exchanges with leading diabetes experts. Join the Science Sessions conversation on social media using #ADA2023.
About the American Diabetes Association
The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve of the diabetes epidemic and help people with diabetes thrive. For 82 years, the ADA has driven discovery and research to treat, manage and prevent diabetes while working tirelessly for a cure. Through advocacy, program development and education, we aim to improve the quality of life for the more than 133 million Americans with diabetes or prediabetes. Diabetes brought us together. What we do next will make us connected for life. To find out more or to get involved, go to diabetes.org or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Spanish Facebook (American Diabetes Association), LinkedIn (American Diabetes Association), Twitter (@AmDiabetesAssn), and Instagram (@AmDiabetesAssn).
Contact: Rebecca Fisher703-253-4918
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SOURCE American Diabetes Association