The effectiveness of adding cognitive behavioural therapy aimed at changing lifestyle to managed diabetes care for patients with type 2 diabetes: design of a randomised controlled trial
Open accessAbstract
BACKGROUND: In patients with type 2 diabetes, the risk for cardiovascular disease is substantial. To achieve a more favourable risk profile, lifestyle changes on diet, physical activity and smoking status are needed. This will involve changes in behaviour, which is difficult to achieve. Cognitive behavioural therapies focussing on self-management have been shown to be effective. We have developed an intervention combining techniques of Motivational Interviewing (MI) and Problem Solving Treatment (PST). The aim of our study is to investigate if adding a combined behavioural intervention to managed care, is effective in achieving changes in lifestyle and cardiovascular risk profile. METHODS: Patients with type 2 diabetes will be selected from general practices (n = 13), who are participating in a managed diabetes care system. Patients will be randomised into an intervention group receiving cognitive behaviour therapy (CBT) in addition to managed care, and a control group that will receive managed care only. The CBT consists of three to six individual sessions of 30 minutes to increase the patient's motivation, by using principles of MI, and ability to change their lifestyle, by using PST. The first session will start with a risk assessment of diabetes complications that will be used to focus the intervention. The primary outcome measure is the difference between intervention and control group in change in cardiovascular risk score. For this purpose blood pressure, HbA1c, total and HDL-cholesterol and smoking status will be assessed. Secondary outcome measures are quality of life, patient satisfaction, physical activity, eating behaviour, smoking status, depression and determinants of behaviour change. Differences between changes in the two groups will be analysed according to the intention-to-treat principle, with 95% confidence intervals. The power calculation is based on the risk for cardiovascular disease and we calculated that 97 patients should be included in every group. DISCUSSION: Cognitive behavioural therapy may improve self-management and thus strengthen managed diabetes care. This should result in changes in lifestyle and cardiovascular risk profile. In addition, we also expect an improvement of quality of life and patient satisfaction. TRIAL REGISTRATION: Current Controlled Trials ISRCTN12666286.
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Cognitive Behavioral Therapy has been shown to improve diabetes self-management programs.
“One such intervention is Cognitive Behavioral Therapy (CBT), which has been shown to improve diabetes self-management programs [3] , [4] and [5] .”
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- Authors
- Welschen, L. M., van Oppen, P., Dekker, J. M., Bouter, L. M., Stalman, W. A., & Nijpels, G.
- Affiliations
- Amsterdam Public Health (NL)
- Corresponding author
- Welschen, Laura MC
- Venue
- BMC Public Health
- Published
- 2007-05-08
- Volume
- 7
- Issue
- 1
- Pages
- 74-74
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC1876216
- OpenAlex
- W1987222965
- Cited by
- 42
- References
- 58
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 1 · 2020: 2 · 2018: 1 · 2016: 4 · 2015: 4 · 2014: 2 · 2013: 4 · 2012: 6
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Vrije Universiteit Amsterdam
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, cognitive behavioral therapy, motivational interviewing, problem-solving therapy, lifestyle modification, cardiovascular risk, self-management, diet, physical activity, smoking, HbA1c, blood pressure, cholesterol, quality of life, patient satisfaction, depression, eating behaviour
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Life Style, Problem Solving, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Disease Management, Self Efficacy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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