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Reducing Diabetes Distress and A1C – An Exciting Study for Type 1 Diabetes

By Adam Brown

A currently-recruiting study will provide access to some of the world’s leading diabetes psychologists, support groups, and strategies to reduce distress and improve blood sugars

Clinical Trials Identifier: NCT04016558

Trial name: Behavioral Approaches to Reducing Diabetes Distress and Improving Glycemic Control (EMBARK)

As of 3/19/20, recruitment for this trial is on hold due to COVID-19; the EMBARK office is evaluating virtual intervention strategies. Contact the office to be added to the growing participant list.

Diabetes type: Type 1

What the trial is testing: This study will test three different approaches to improve A1C levels and reduce diabetes distress. All three programs include at least one in-person group meeting run by a leading diabetes psychologist, followed by ongoing personal contact with diabetes specialists (phone, video chat). Depending on the program, there will be more focus on targeting diabetes distress and emotions, more focus on blood glucose management skills, or a blend of the two. All three approaches have shown they are effective at reducing diabetes distress; however, this large, NIH-funded study has consolidated and enhanced the strategies, aiming to increase the effect.

What the trial is measuring: This trial is measuring the change in self-reported diabetes distress from study start to 12 months; and change in A1C from study start to 12 months. The in-person component is just one or two meetings – most of the study takes place remotely.

Why is this new/important? Diabetes distress refers to the often-unrecognized worries, concerns, and fears associated with managing diabetes. High diabetes distress is characterized by frustration, feeling overwhelmed, and feeling hopeless and discouraged by the constant demands of the disease. Distinct from depression, diabetes distress is prevalent in a sizeable percentage of people with type 1 diabetes at any given time. It has been linked to challenges in managing blood sugars, difficulty taking medication as prescribed, and lower quality of life. Recent research on reducing diabetes distress is promising – interventions are effective over time.

Trial length: 12 months

Trial locations: The research team is open to any US city where there is enough interest; email them at the address below. Sites are currently recruiting in the San Francisco Bay Area; San Diego; and Portland, OR. More sites are welcome!

Select eligibility criteria include:

  • Diagnosed with type 1 diabetes for at least one year

  • 19 years and older

  • A recent A1C of 7.5% or above

  • A high level of diabetes distress assessed at screening

Where to get more information: Contact the EMBARK office at or (855) 850-3599.

3/19/20: If you are interested in participating in EMBARK please feel free to contact the office via email or phone; you will be added to a growing participant list. You will be contacted directly once the trial gets going again.

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