Background: 50% of people with diabetes are living with too high blood sugars and increased
risk of diabetes related complications together with poor quality of life. The need to
improve diabetes care by better enabling patients to utilise their individual and local
resources to self-manage the condition is widely recognized, yet there is a lack of access to
evidence-based patient-centred healthcare interventions. At present the individual patient's
judgement of own concrete situation mostly remains unexplored and insufficiently used in
decision-making causing that problems perceived by the patient in living with the illness
remain unrecognised and insufficiently resolved.
Aim and Methods: Guided self-determination (GSD) is an educational method developed to
promote patient autonomy, participation, skills building and intrinsic motivation. In this
evidence-based group-intervention the main objective is to implement and evaluate GSD through
a randomised controlled trial. GSD methods will be performed seven times for the intervention
group. The control group will receive traditional out-patient consultations - 'care as usual'
Outcome measures will be performed at baseline, after 9 and 18 months. The project will focus
on adults with type 1 diabetes (18-55 yrs) where an improvement will be highly cost-effective
in preventing late complications and enhanced psychosocial health. GSD is presumably an
intervention providing psychosocial support applicable in busy clinical practice.
An alliance is established between Haukeland University Hospital, Norway and Steno Diabetes
centre, Copenhagen, Denmark, Centre of Evidence-Based Practice, Bergen University College,
and Bergen University to conduct this intervention and thus make the best possible use of
interrelated knowledge within the issue.