Effectiveness of cognitive–behavioural therapy on glycaemic control and psychological outcomes in adults with diabetes mellitus: a systematic review and meta‐analysis of randomized controlled trials

Abstract

Uchendu, C. and Blake, Holly (2016) Effectiveness of cognitive-behavioural therapy on glycaemic control and psychological outcomes in adults with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Diabetic Medicine, 34 (3 A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. Aim: This systematic review and meta-analysis aims to establish the effectiveness of CBT on glycaemic control and co-morbid diabetes-related distress, depression, anxiety and quality of life in the short, medium and longerterm among adults with diabetes.Method: Electronic search was conducted in PubMed, Embase, MEDLINE, PsycINFO, CINAHL, Web of Knowledge, Cochrane Central Register of Controlled Trials and references in reviews. 12 randomised controlled trials (RCTs) were identified which evaluated the effectiveness of CBT on at least one of: glycaemic control, diabetes-related distress, anxiety, depression or quality of life in adults with Type 1 or Type 2 diabetes. Cochrane risk of bias tool and review manager version 5.3 were used for risk of bias assessment and meta-analysis respectively.Results: CBT is effective in reducing short-term and medium-term glycaemic control although no significant effect was found for long-term glycaemic control. CBT improved short and medium-term anxiety and depression, and long-term depression. Mixed results were found for diabetes-related distress and quality of life. Conclusion:CBT is beneficial for adults with diabetes in improving depression. It may have benefits for improving glycaemic control and other aspects of psychological health although findings are inconclusive.

Cognitive behavioural therapy on improving the depression symptoms in patients with diabetes: a meta-analysis of randomized control trials

“…Furthermore, we evaluate the efficacy of CBT on depression at post-intervention and 12 months after follow up. In addition, we performed the subgroup analyses and found the impact of evaluation criteria of depression on results, which was not shown in the previous meta-analysis [16]. …”

“…Compared with the recent meta-analysis [16], we excluded the studies of Amsberg et al [22] and Snoek et al [21] because of incomplete outcome data and high risk of attrition bias. In addition, the studies of der Ven et al [18] and Hermanns et al [17] were first analyzed in this meta-analysis.…”

“…Currently, many studies also investigated the effect of CBT on improving the depression symptoms in patients with diabetes [13–15]. Although a recent meta-analysis has proved the effectiveness of CBT on depression in patients with diabetes [16], evidence was not strong enough due to some limitations. Firstly, not all relevant studies were included in this previous meta-analysis [17–19].…”

Anxiety and depressive disorders in children and adolescents suffering from diabetes mellitus

“…It is still unclear whether interventions for anxiety and depression influence DM characteristics, such as glycaemic control or others. CBT might be effective in reducing short-term and medium-term glycaemic control, without significant effects for long-term glycaemic control 78 .…”

Web-Based Interventions for Depression in Individuals with Diabetes: Review and Discussion (Preprint)

“…Both approaches have shown to be effective in face-to-face treatment of depression [45,46]. However, face-to-face CBT is the most extensively researched psychotherapeutic treatment for depression [46] and have also shown to be effective in depression symptomatology [47] and glycemic control [48] in individuals with diabetes. Congruently with this review, CBT is also the most commonly used approach in web-based depression interventions [49][50][51].…”