Trial reportDiabetes care2024
EMBARK: A Randomized, Controlled Trial Comparing Three Approaches to Reducing Diabetes Distress and Improving HbA1c in Adults With Type 1 Diabetes.
Trial report in Diabetes care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Emotional distress as a therapeutic target against persistent poor glycaemic control in subjects with type 1 diabetes: A systematic review.Diabetes, obesity & metabolism · 2025Pooled it
- How does addressing diabetes distress lead to positive glycemic change? Results from the EMBARK trial.Patient education and counseling · 2026Trial
- THR1VE!: Randomized controlled trial to reduce diabetes distress in adolescents with type 1 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2025Trial
- Joint effect of nicotine use and diabetes distress on glycemic control in young adults with type 1 diabetes.Journal of diabetes and its complications · 2025Trial
- Frequency of Key Type 1 Diabetes Self-Care Behaviours Are Associated With Psychological Flexibility, Distress and Glycaemic Outcome.Endocrinology, diabetes & metabolism · 2026Article
- Group-based interventions to reduce diabetes distress in adults with type 1 diabetes: A rapid realist review of the Reduce and TunedIn interventions.Diabetic medicine : a journal of the British Diabetic Association · 2026Review
- D-ACTnow-A diabetes-specific group-based psychological intervention for young adults with type 1 diabetes and elevated diabetes distress: Results from a single-arm pilot study.Diabetic medicine : a journal of the British Diabetic Association · 2026Article
- Article
- Living with what is lost: reframing emotional life with diabetes through an integrative perspective on loss and grief.Frontiers in clinical diabetes and healthcare · 2026Article
- 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Diabetes-Related Distress and Glycemic Dysregulation in Everyday Life With Type 1 Diabetes: Which Comes First?Diabetes care · 2025Observational
- The effects of self-compassion in adolescents and young adults with type 1 diabetes: a pilot randomized controlled trial.Annals of pediatric endocrinology & metabolism · 2025Article
- 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- Addressing the Emotional Side of Diabetes During Pregnancy: A Scoping Review With Implications for Intervention.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- Addressing emotional distress to improve outcomes in adults with type 1 diabetes: Protocol for ACT1VATE randomized controlled trial.Contemporary clinical trials · 2024Article
- Depression in patients with diabetic retinopathy.Proceedings (Baylor University. Medical Center) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
objectiveTo compare the effectiveness of three interventions to reduce diabetes distress (DD) and improve HbA1c among adults with type 1 diabetes (T1D). RESEARCH DESIGN AND
methodsIndividuals with T1D (n = 276) with elevated DD (a score >2 on the total Type 1 Diabetes Distress Scale) and HbA1c (>7.5%) were recruited from multiple settings and randomly assigned to one of three virtual group-based programs: 1) Streamline, an educator-led education and diabetes self-management program; 2) TunedIn, a psychologist-led program focused exclusively on emotional-focused DD reduction; or 3) FixIt, an integration of Streamline and TunedIn. Assessments of the primary outcomes of DD and HbA1c occurred at baseline and at 3, 6, and 12 months.
resultsAll three programs demonstrated substantive and sustained reductions in DD (Cohen's d = 0.58-1.14) and HbA1c (range, -0.4 to -0.72) at 12-month follow-up. TunedIn and FixIt participants reported significantly greater DD reductions compared with Streamline participants (P = 0.007). Streamline and TunedIn participants achieved significantly greater HbA1c reductions than did FixIt participants (P = 0.006).
conclusionsDD can be successfully reduced among individuals with T1D with elevated HbA1c using both the educational/behavioral and emotion-focused approaches included in the study. Although both approaches are associated with significant and clinically meaningful reductions in DD and HbA1c, TunedIn, the emotion-focused program, had the most consistent benefits across both DD and HbA1c. The study findings suggest the overall value of group-based, fully virtual, and time-limited emotion-focused strategies, like those used in TunedIn, for adults with T1D.
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