Nurse-delivered e-cognitive behaviour therapy intervention for type 1 diabetes patients King’s College Hospital NHS Foundation Trust

This project led by a team at King’s College Hospital NHS Foundation Trust investigated whether a virtual setting is an effective alternative method of delivering cognitive behavioural therapy (CBT) for diabetes patients.

Diabetes is a chronic condition that puts a lot of stress on patients’ lives and demands high self-motivation to maintain therapy regimes and lifestyle changes. Over half of patients with type 1 diabetes (T1DM) do not have optimal glycaemic control. Face to face CBT has been shown to be effective in helping patients manage their diabetes. However, many patients cannot attend regular face to face sessions: they may live too far away, have working hours that are incompatible with the usual timeframe or have dependents.

Through this project, an integrated system to deliver online therapy to patients with T1DM who are struggling to achieve glycaemic control was developed. Diabetes Online Therapy (DOT) was delivered via text, over the internet, by diabetes specialist nurses trained to administer CBT and integrated with usual diabetes care. Patients were recruited from King’s College Hospital and a number of affiliated/satellite hospitals in South London. The CBT consisted of 10 sessions each lasting 50 minutes, via an online messenger system, augmented using motivational enhancement tools via a smart phone app.

Six diabetes specialist nurses have completed their training and 68 patients have been recruited. Interim data have shown a mean improvement in blood glucose control (HbA1c) of 7mmol/mol, and in measures of psychological health of the patients over the course of the treatment.

Challenges included fitting CBT sessions into the busy NHS schedule and identifying those patients who are most likely to benefit from DOT. 

Contact details

For further information about the project, please email Anne Doherty at King’s College Hospital NHS Foundation Trust.