THR1VE!: Randomized controlled trial to reduce diabetes distress in adolescents with type 1 diabetes
Authors' conclusion
There was no significant intervention effect on DD or HbA1c. Adolescents in both the Diabetes Education and Diabetes Education + Positive Affect arms reported reduced DD over 12 months. Future studies are needed to determine how to employ the least burdensome, engaging intervention for distressed adolescents.
Study context
- Population
- Adolescents aged 13–17 with T1D and elevated diabetes distress (DD), and their caregivers, 2 sites
- Participants
- 198 dyads
- Comparison
- Diabetes Education + Positive Affect intervention vs enhanced usual care (Diabetes Education), via automated text messages
- Primary endpoint
- Changes in DD and HbA1c
- Follow-up
- 12 months
Methodological details2 sites
- 2 sites
Primary result
As reported in the abstract
Reductions in DD from baseline to 12 months in both groups (effect size d)
0.40
More likely to move from clinically relevant into normal range of DD than to report increased DD (OR)
2.2
p = 0.002
Further findings
Association of DD improvement with HbA1c · over time
- Improvement in DD associated with decreased HbA1c (β)
- 1.89, p = 0.02
Engagement · 12 months
- Overall response to text messages
- 91%
- Retention
- 90%
Original publication
THR1VE!: Randomized controlled trial to reduce diabetes distress in adolescents with type 1 diabetes. Diabet Med. Published 16 July 2025. doi:10.
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