Effects of mindfulness- and acceptance-based interventions on diabetes distress and glycaemic level in people with type 2 diabetes: Systematic review and meta-analysis

Author: Hau Yi Ngan1, Yuen Yu Chong1, Wai Tong Chien1
1 The Nethersole School of Nursing Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Conference/Journal: Diabet Med
Date published: 2021 Jan 12
Other: Special Notes: doi: 10.1111/dme.14525. , Word Count: 255

For people with type 2 diabetes, self-management and fear of disease complication often cause psychological distress. Mindfulness and acceptance might be beneficial for reducing diabetes-related distress and glycaemic level. We systematically review the effects of mindfulness- and acceptance-based interventions on diabetes distress and glycaemic level in community-dwelling adults with type 2 diabetes.

Seven electronic databases (English and Chinese) were searched comprehensively from inception to June 2020. Data extraction and methodological quality assessment were independently performed by two reviewers using Grading of Recommendations, Assessment, Development and Evaluations criteria.

Nine RCTs (801 participants) examining the effects of acceptance and commitment therapy, mindfulness-based cognitive therapy, mindfulness-based stress reduction and self-directed mindfulness practice were included. In the reviewed RCTs, the majority of participants (mean age: 50-66 years, average disease duration: 4-10 years) had suboptimal diabetes control (HbA1c >7.0%, 53mmol/mol). Compared with controls, the interventions significantly reduced diabetes distress (standardised mean difference, SMD = -0.37, 95% confidence intervals, CI: -0.63, -0.12; P < 0.01) and HbA1c (mean difference, MD = -0.35, 95% CI: -0.67, -0.04; P = 0.03) up to one-month post-intervention. However, the underpowered studies may have led to overestimation, the interventions for diabetes distress and HbA1c were heterogeneous.

Within evidenced-based diabetes education programmes, mindfulness- and acceptance-based approaches may reduce distress and HbA1c levels and promote self-care in people with type 2 diabetes. Further controlled trials are recommended to examine the clinical effectiveness of such programmes for people with type 2 diabetes of diverse clinical, cultural and socio-demographic backgrounds.

Keywords: HbA1c; acceptance; mindfulness; psychological distress; systematic review; type 2 diabetes.

PMID: 33438251 DOI: 10.1111/dme.14525