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Articles by J. W. R. Twisk
Total Records ( 1 ) for J. W. R. Twisk
  F. J. Snoek , N. C. W. Van Der Ven , J. W. R. Twisk , M. H. E. Hogenelst , A. M. E. Tromp-Wever , H. M. Van Der Ploeg and R. J. Heine
  Objective  To test the effectiveness at 6 and 12 months' follow-up of group cognitive behavioural therapy (CBT) compared with blood glucose awareness training (BGAT) in poorly controlled Type 1 diabetic patients and to explore the moderating effect of baseline depression.

Research design and methods  Adults with Type 1 diabetes (n = 86) with glycated haemoglobin (HbA1c) ≥ 8% were randomized to CBT or BGAT. Primary outcome was HbA1c control. Secondary outcomes were: self-care, diabetes-related distress (Problem Areas in Diabetes scale; PAID), diabetes self-efficacy (Confidence in Diabetes Self-care scale; CIDS) and depressive symptoms (Centre for Epidemiological Studies - Depression scale; CES-D). Measurements were scheduled before CBT and BGAT, and at 3, 6 and 12 months after. Differential effects were analysed for the subgroup of patients reporting low vs. high baseline levels of depression.

Results  Neither CBT nor BGAT had a significant impact on HbA1c at 6 and 12 months' follow-up. Both interventions resulted in lower depressive symptoms (CES-D 15.7-13.3, P = 0.01) up to 12 months, but only CBT was effective in lowering HbA1c in patients with high baseline depression scores (HbA1c 9.5-8.8%) up to 1 year of follow-up (P = 0.03).

Conclusions  Our findings suggest that group CBT can effectively help Type 1 diabetic patients with co-morbid depression achieve and maintain better glycaemic outcomes.

 
 
 
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