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Problem Solving Training to Enhance Dietary Self-management in a Diabetic Patient

A central aspect of self-management of diabetes involves patients regulating the timing and intake of dietary carbohydrates. A 20 year old female diabetic patient was taught to identify deviations from appropriate dietary self-management, and a problem solving intervention was used to train new behavior in settings associated with such deviations. Dietary behavior and blood glucose levels were monitored in a diary and electronically, and treatment effects were evaluated in a multiple baseline across settings design. Treatment resulted in clear improvement in dietary management, and a substantial gain in blood glucose control at the end of intervention. At follow-up dietary change was maintained. Long term effects on blood glucose levels were confounded by a reduction in insulin dosage between treatment and follow-up.