Purpose: The purpose of this study was to determine the efficacy of a multidisciplinary intervention program to improve the glycemic-control of children with type 1 diabetes mellitus (T1DM) compared to a control group.
Methods: This randomized controlled trial included 92 children, aged 5-18 years with inadequately controlled T1DM. Each child in the intervention group received, in addition to the standard care at the diabetic clinic, home and school visits by a multidisciplinary team during one year. Metabolic control was assessed by HbA1c levels, hypoglycemia monthly rates, and number of hospitalizations, by comparison of these measures with the year previous to the study period in each group.
Results: Mean HbA1c levels and hypoglycemic monthly rates were similar in both groups before and during the trial. The results of the multivariate interaction models show a change between the study groups through the follow-up period: a decline in HbA1c levels in the intervention group vs. a rise in the control group; p of interaction = 0.027 and a rise in hypoglycemia monthly rates in the intervention group vs. a decline in the control group; p of interaction = 0.035. There was no significant change in the number of hospitalizations in both groups.
Conclusion: The multidisciplinary intervention program led to only a minor change in HbA1c levels. It might be possible that a similar but more intensive and extended program would make a greater clinical impact on glycemic-control.
