The Impact of Motivational Interviewing on HbA1c and More in Type 1 Diabetic Youth: A Systematic Review

Timothy Hunt

Background:

Type 1 Diabetes Mellitus (T1DM) is a condition with chronic complications such as retinopathy, nephropathy and neuropathy. Hyperglycaemia is a common risk factor for these complications, which can be monitored by HbA1c levels. Lifestyle changes such as regular exercise and a healthy diet are essential in regulating these levels, resulting in a better prognosis.  Children and adolescents have the highest incidence of T1DM and are known to engage in poor lifestyle behaviours such as physical inactivity and unhealthy eating habits.  Motivational interviewing (MI) is a collaborative communication intervention that promotes behavioural change in patients. MI has shown promise in reducing HbA1c levels in patients with Type 2 Diabetes Mellitus, but minimal research has been conducted investigating its performance in T1DM.

Objective:

This review sought to evaluate the impact of MI interventions on HbA1c levels in T1DM Patients under 18 years-of-age, and identify other outcomes addressed in the literature.

Method:

 APA PsycINFO, JBI EPB, Emcare and MEDLINE databases were searched. Inclusion criteria were human studies of patient populations 0-18 years of age in the English language. Studies were deduplicated and assessed by title, abstract and full text.

Results:

9 studies resulted from the systematic search. MI was found to reduce HbA1c in six out of nine studies with the other three indicating no significant change. Other impacts of MI identified included improved self-management of T1DM, increased quality of life and enhanced dietary quality.

Conclusion:

This review demonstrates potential for MI as an intervention for the management of Paediatric Type 1 Diabetics, particularly in the reduction of HbA1c levels. Further research is required to increase clinical confidence in the impact of MI and optimise its delivery.