Effects of Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy in People With Diabetes: A Systematic Review and Meta‐Analysis

Abstract

Purpose The purpose of this study was to determine the effectiveness of mindfulness‐based stress reduction (MBSR) and mindfulness‐based cognitive therapy (MBCT) on depression, quality of life (QoL), and glycosylated hemoglobin (HbA1c) in people with diabetes. Design A systematic literature review and meta‐analysis was conducted. Methods Eight databases (PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], Cochrane, PsycINFO, and three Chinese databases) were searched for relevant studies from inception to December 2019. Only randomized controlled trials (RCTs) of MBSR and MBCT interventions for people with type 1 and type 2 diabetes were included. Findings Nine studies described in 11 articles were included in the review. Meta‐analysis showed a significant effect favoring MBSR and MBCT on depression (standardized mean difference ‐0.84; 95% confidence interval [CI] ‐1.16 to ‐0.51; p < .0001), the mental health composite score of QoL (mean difference [MD] 7.06; 95% CI 5.09 to 9.03; p < .00001), and HbA1c (MD ‐0.28; 95% CI ‐0.47 to ‐0.09; p = .004). However, effects on the physical health composite score of QoL have not been found. Conclusions MBSR and MBCT are beneficial in improving depression, the mental health composite score of QoL, and HbA1c in people with diabetes. More well‐designed trials using longer follow‐up measurements are needed. Clinical Relevance MBSR and MBCT could be considered as effective complementary treatment alternatives for people with diabetes.

Changes Induced by Mind–Body Intervention Including Epigenetic Marks and Its Effects on Diabetes

“…Meta-analysis of eight RCTs conducted on diabetics (including types 1 and 2) revealed that MBI has a beneficial effect on HbA1c, diabetes-related distress, depression, and stress [87]. The fact that MBI positively affects HbA1c is consistent with previous metaanalyses [104,105].…”

“…The fact that MBI positively affects HbA1c is consistent with previous metaanalyses [104,105]. Another study that conducted a meta-analysis of nine RCTs involving diabetics (including types 1 and 2) observed that MBSR and mindful cognitive therapy (MBCT) improved depression, the mental health composite score of quality of life (QOL), and HbA1c [87]. Sensitivity analysis revealed that the positive effect on HbA1c disappeared when long-term tracking studies (more than 6 months) were excluded, suggesting that the effects of MBSR or MBCT on HbA1c takes time to happen.…”

Efeitos de intervenção focada no comportamento alimentar e de prescrição dietética em pacientes com Diabetes Tipo 1: um estudo piloto

“…Atualmente, observa-se que técnicas complementares à prescrição dietética estão cada vez ganhando mais espaço no tratamento nutricional do indivíduo com diabetes, como as intervenções com técnicas de atenção plena (mindfulness 1 ) (Ellis et al, 2019;Ni et al, 2020), comer com atenção RBTCC 24 (2022 plena (mindful eating 2 ) (Miller, Kristeller, Headings, Haikady Nagaraja, & Miser, 2012;Miller, Kristeller, Headings, & Nagaraja, 2014;Mason et al, 2019), intervenções culinárias (Byrne et al, 2017;Dexter et al, 2019) e comer intuitivo (Quansah et al, 2019;Soares et al, 2020;Wheeler et al, 2016).…”

“…Na literatura científica, os estudos sobre mindfulness com pessoas com DM usualmente utilizam intervenções com eficácia já comprovada a partir de ensaios clínicos randomizados, como o Mindfulness-Based Stress Reduction (Ellis et al, 2019;Ni et al, 2020) e o Mindfulness-Based Cognitive Therapy (Haenen et al, 2016), e os resultados na população tanto com DM1 quanto Diabetes Tipo 2 (DM2) apontam para redução de sintomas de ansiedade, depressão, estresse relacionado ao diabetes (Whitebird et al, 2018;Ni et al, 2020), melhora da qualidade de vida e redução da hemoglobina glicada (Ni et al, 2020;Son et al, 2013).…”

Effectiveness of a nurse‐led mindfulness stress‐reduction intervention on diabetes distress, diabetes self‐management, and HbA1c levels among people with type 2 diabetes: A pilot randomized controlled trial

“…We systematically combed existing literature and found a meta‐analysis that showed that MBSR can reduce diabetes distress with an effect size of 0.58 (Guo et al, 2019). Another meta‐analysis showed that the MBSR therapy decreased HbA1c levels in people with diabetes (effect size = 0.28; 95% confidence interval [CI]: −0.47 to −0.09; p = 0.004) (Ni et al, 2020). However, there are some obstacles to implementing the conventional MBSR with an attrition rate of up to 39% (Guo et al, 2019), which include an absence of experts in healthcare organizations who can deliver the intervention and high rates of attrition.…”