Self-management education and psychological support improve self-esteem in people with type 1 diabetes

Self-management of type 1 diabetes requires behaviors that include blood glucose monitoring, carbohydrate counting, insulin administration and physical activity in the context of technical knowledge and daily emotions, with complex psychological implications that may influence glycaemic control and well-being. Over the past 20 years we have developed the Group Care model to support patients by strategies aimed at overcoming anxiety and promoting self-esteem. Three patients were lost to follow-up. HbA1c and severe hypoglycemias showed a trend to decrease. Quality of life improved, globally and in the treatment satisfaction and disease impact dimensions, together with self-esteem, anxiety and depression. By Group Care we aim at encouraging self-reflection on personal experience and exploit such exercise to acquire more flexibility when facing life events, acknowledging their potentially positive aspects despite the presence of disease. Improvements in satisfaction with treatment and impact of disease support the efficacy of the educational process, while increased self-esteem and diminished anxiety and depression suggest strengthened problem-solving strategies.