In people with poorly controlled type 1 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months

Context Type 1 diabetes is associated with a range of biopsychosocial consequences.1 Treatment targets self-care (eg, diet, exercise, medication) aimed at optimising glycaemic control thus minimising the risk of medical/health complications. However, between quarter and half of all adults with type 1 diabetes have suboptimal glycaemic control.1 Maintaining behaviour changes in the absence of immediate consequences is a particular challenge for people with type 1 diabetes. Psychological approaches aimed at enhancing motivation and initiating and maintaining behaviour change may help improve glycaemic control.1 CBT aims to assist the patient develop helpful thoughts and behaviours to facilitate optimal health behaviours.2 Motivational interviewing aims to explore and resolve ambivalence, thus enhancing the patient s readiness to change.