Evaluation of a Diabetes Coach Program Aimed to Improve the Care of Children and Youth With Type 1 Diabetes and With Compromised Control

To evaluate the impact of the Diabetes Coach Program (DCP) on glycated hemoglobin (A1C) levels in youth with type 1 diabetes. The youth were referred to and participated in the DCP between October 2011 and May 2016. The Diabetes Coach visited families in their homes every 1 to 2 weeks and updated patients' diabetes teams regularly. A1C levels before the DCP were compared with A1C levels during and after discharge from the DCP. Six participating families completed satisfaction surveys via telephone. The DCP included 23 participants (43% male; median age, 11 years; range, 8.8 to 14.5 years); median duration of type 1 diabetes, 1.7 years (range, 0.1 to 6.3 years); median time in the DCP, 1.5 years (range, 0.2 to 2.5 years). During involvement in the program, median A1C levels decreased from baselines of 11.1% (range, 8.9% to 15.3%) to 10.2% (range, 7.6% to 12.4%) (p=0.0028). For 11 of 13 patients discharged from the DCP, the most recent median A1C levels, 11.2% (range, 9.1% to 13.6%), an average of 2.4 years later, were not different from the initial A1C levels (p=0.85). Family feedback was overwhelmingly positive. Participation in the DCP decreased A1C values in pediatric patients; however, the levels were not sustained after visits stopped. Pediatric health coaches may play an important role in the management of type 1 diabetes, but further research is needed to explore their benefits and how positive effects can be sustained. Évaluer les répercussions du Diabetes Coach Program (DCP) sur les concentrations de l'hémoglobine glyquée (A1c) chez les jeunes atteints du diabète de type 1. Les jeunes ont été orientés vers le DCP et y ont participé entre octobre 2011 et mai 2016. L'accompagnateur en diabète a visité les familles à leur domicile 1 fois par semaine ou toutes les 2 semaines et a fait régulièrement le point sur les patients auprès des équipes en diabète. Les concentrations de l'A1c avant la participation au DCP ont été comparées aux concentrations de l'A1c pendant et après la participation au DCP. Six familles ont participé aux enquêtes par téléphone sur la satisfaction. Le DCP a regroupé 23 participants (43 % d'hommes; âge médian, 11 ans; étendue, de 8,8 à 14,5 ans); durée médiane du diabète de type 1, 1,7 an (étendue, de 0,1 à 6,3 ans); temps médian de la participation au DCP, 1,5 an (étendue, de 0,2 à 2,5 ans). Durant la participation au programme, les concentrations médianes initiales de l'A1c sont passées de 11,1 % (étendue, de 8,9 % à 15,3 %) à 1