Arne Kooistra1, Helen L. Lutgers2, Andre P. van Beek2
1 Centre for Rehabilitation, Diabetes Rehabilitation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
2 Department of Endocrinology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
a.kooistra01@umcg.nl
Background: Many individuals with diabetes mellitus continue to struggle with achieving both glycemic control and psychological well-being. Despite the availability of hybrid closed-loop systems and growing psychological expertise, a substantial group still fails to meet treatment goals. To address this, a multidisciplinary diabetes rehabilitation program was developed at the University Medical Center Groningen.
Methods: This preliminary analysis reports on a prospective cohort of individuals who had not achieved sufficient progress with conventional care. The structured 14-week intervention included a 4-week inpatient and 10-week outpatient phase, combining medical, psychological, and paramedical care. Outcomes were assessed at four time points: pre-treatment, start of inpatient phase, end of outpatient phase, and one-year follow-up.
Results: The cohort included 86 participants (type 1 diabetes 93% / type 2 diabetes 7%). In the nine months prior to the program, no significant change in HbA1c was observed (t(59) = 0.74, p = .462, d = 0.10). Following the intervention, glycemic control improved significantly, with a mean HbA1c reduction of 1.7% (19 mmol/mol) (t(85) = 10.01, p < .001, d = 1.08). Psychosocial outcomes also improved: diabetes-related distress decreased (t(59) = 12.55, p < .001, d = 1.26), and emotional well-being increased (t(62) = -8.36, p < .001, d = 1.07). Fear of hypoglycemia declined in both subscales; behavior (N = 63, z = -4.32, p < .001, r = 0.54) and concern (N = 63, z = -4.79, p < .001, r = 0.60). No significant change in HbA1c was found between the end of the program and one-year follow-up (N = 36, z = 1.17, p = .241, r = 0.20).
Conclusion: This preliminary evaluation suggests that multidisciplinary rehabilitation can result in meaningful improvements in glycemic control and psychosocial functioning for individuals with persistent treatment challenges.