Background: We evaluated the impact of a 2-year chat line involving adolescents with type 1 diabetes regarding quality of life and metabolic control. Methods: We enrolled 193 children, 10-18 years of age (mean +/- SD, 13.6 +/- 2.7 years), with type 1 diabetes for 1.2-6 years (3.6 +/- 2.4 years), body mass index of 23.2 +/- 4.1 kg/m(2), insulin requirement of 0.7 +/- 0.3 U/kg/day, and glycated hemoglobin (HbA1c) of 7.8 +/- 1.1%, who participated in a weekly physician-moderated chat line for a 2-year follow-up period. Each patient completed the Diabetes Quality of Life for Youth Inventory (DQOLY) at baseline and after 1 and 2 years. A measure of glycemic control (HbA1c) was also collected. Data from 17 patients who discontinued using the chat line were not included in the analysis. As controls, 203 patients with type 1 diabetes, age-and sex-matched, with similar HbA1c at baseline and socioeconomic status, were randomly selected among 834 patients who refused to participate in the chat sessions. Results: DQOLY responses from youth with type 1 diabetes showed a significant improvement (P = 0.0001) only in patients who participated in chat sessions. We observed a decrease of 0.4% in HbA1c in patients who participated in chat session (7.8 +/- 1.1% vs. 7.4 +/- 0.5%, P < 0.0001) compared with the 0.1% of the controls (7.9 +/- 1.9% vs. 7.8 +/- 1.8%, P = 0.668). No difference was observed in HbA1c between the two groups (P = 0.056). Conclusions: A chat line is also a cheap and effective tool that helps improve diabetes compliance. The chat line could help the diabetes team understand and treat their patients more comprehensively; moreover, it could help patients cope better with their daily life.