Study type: Single-arm pilot study.
In plain language
Managing type 1 diabetes involves repeated daily tasks that can be difficult to sustain during emerging adulthood. Styles and colleagues explored whether linking self-management actions to personally chosen values could make those actions more meaningful and achievable. Their pilot included 14 participants aged 18–25 with HbA1c of at least 7.5% (58 mmol/mol).
Participants received a 30–60 minute individual session informed by acceptance and commitment therapy. They clarified values, chose a self-management behavior to work on, considered barriers, and developed an action plan. At a two-week follow-up they reviewed and, where needed, revised their plans. Blinded continuous glucose monitoring measured glucose time in range; self-report outcomes were followed for up to four weeks.
Participants generally valued the personalized and nonjudgmental approach. Progress toward valued living improved. The average increase in glucose time in range was small and uncertain, however, so the study supports further testing rather than a conclusion that this brief intervention improves glucose control.
Key points
- The intervention was brief and feasible in this pilot. Sixteen participants enrolled, 14 received the intervention, and 12 completed all assessments. Feedback favored the focus on personally meaningful, achievable changes.
- The glucose finding was inconclusive. Mean time in range increased from 33.8% to 36.0%, a change of 2.2 percentage points (95% CI −1.2 to 5.7). The interval includes no improvement, and the average change fell below the paper’s threshold for a clinically meaningful improvement.
- Progress toward values showed the clearest change. The standardized mean change in progress toward valued living was 0.72 (95% CI 0.27 to 1.16). Changes in other psychosocial measures were smaller and uncertain.
- Individual responses varied. Eight of 14 participants had an increase in time in range exceeding five percentage points. Without a comparison group, these individual changes cannot establish an intervention effect.
What the paper does and does not establish
- The single-arm design cannot separate intervention effects from natural fluctuation, time, or other influences. This small pilot was not powered to provide a definitive effectiveness test.
- Follow-up was short, recruitment and retention were affected by the COVID-19 pandemic, and the sample may favor people willing and able to engage in this kind of support.
- The authors call for a larger randomized trial with an active comparison treatment and longer follow-up. The study should not be presented as proof that a single values session improves glycemic control.
How to cite
APA 7
Styles, S. E., Haszard, J. J., Oravcova-Wheeler, Z., Campbell, A., Arroll, B., Ciarrochi, J., Hayes, L., Lemon, J., Ketu-McKenzie, M., & Wheeler, B. J. (2026). Preliminary outcomes of a brief values-guided self-management intervention to improve glucose levels among emerging adults with type 1 diabetes and above-recommended HbA1c: A pilot study. Endocrinology, Diabetes & Metabolism, 9(4), Article e70255. https://doi.org/10.1002/edm2.70255
BibTeX
@article{styles2026values,
title = {Preliminary outcomes of a brief values-guided self-management intervention to improve glucose levels among emerging adults with type 1 diabetes and above-recommended HbA1c: A pilot study},
author = {Styles, Sara E. and Haszard, Jillian J. and Oravcova-Wheeler, Zuzana and Campbell, Anna and Arroll, Bruce and Ciarrochi, Joseph and Hayes, Louise and Lemon, Jim and Ketu-McKenzie, Miriama and Wheeler, Benjamin J.},
journal = {Endocrinology, Diabetes & Metabolism},
year = {2026},
volume = {9},
number = {4},
pages = {e70255},
doi = {10.1002/edm2.70255}
}
Related work
- The Process-Based Assessment Tool (PBAT)
- Clinician perspectives on process-based therapy
- One size fits none: A call for an idionomic revolution
- All publications by Joseph Ciarrochi
Summary based on the full published open-access article supplied by the author. The local PDF is the publisher version. Trial registration: ACTRN12620000200987. Summary prepared from the full paper on 29 September 2026. Please cite the published article linked above.