Managing type 2 diabetes and depression with Mindfulness-integrated Cognitive Behavior Therapy (MiCBT)

Abstract

Diabetes Mellitus (DM) is the most common metabolic disorder and the most common cause of death in eastern populations, with prevalence estimated to be at the level of epidemic illness. Despite medical attention, psychological factors remain a significant contributor to DM, requiring effective psychological interventions. This study evaluated the effects of Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) on depression, treatment adherence, and control of blood glucose of 25 Iranian patients (11 males and 14 females, mean age = 45.6) with type 2 DM, randomly assigned to either an 8-session MiCBT (n = 12) or treatment-as-usual (TAU) (n = 13). We present a theoretical conceptualization and detailed step-by-step implementation of MiCBT, and an assessment of its effectiveness in this sample. While no between-group differences were found at pre-treatment on any of the measures, the MiCBT group showed a significantly greater reduction in depression and greater treatment adherence than the TAU group at post-treatment. The MiCBT group also showed a significantly greater blood sugar reduction than the TAU group at 6-week follow-up. Within-group analysis found no significant change on any of the measures for TAU, whereas the MiCBT group reported a significant decrease in depression and increase in treatment adherence from pre- to post-treatment and maintained at 6-week follow-up. Blood sugar reduction also only occurred in the MiCBT group from pre- to post-treatment. Replication studies with larger samples are necessary to confirm these findings and validate the transdiagnostic efficacy and transcultural applicability of MiCBT in type 2 DM.

Relationship between Glucagon-like Peptide-1 Receptor Agonists and Cardiovascular Disease in Chronic Respiratory Disease and Diabetes

“…In a previous study, the use of AGI was associated with a significantly lower risk of hospitalizations due to major atherosclerotic events, ischemic stroke, and hypoglycemia, in line with our results [37]. Similar to previous studies, psychological therapy may attenuate the risk of glucose fluctuations, leading to a lower stroke risk [38].…”

Differentiating mindfulness-integrated cognitive behavior therapy and mindfulness-based cognitive therapy clinically: the why, how, and what of evidence-based practice

“…Randomized controlled trials (RCTs) have provided evidence that MiCBT is efficacious in treating anxiety and depression in pregnant women ( Yazdanimehr et al, 2016 ), in women with multiple sclerosis ( Bahrani et al, 2017 ), and in men and women with type 2 diabetes ( Sohrabi et al, 2022 ). Other studies report MiCBT to be efficacious in managing and reducing chronic pain ( Cayoun et al, 2020 ) and increasing pain self-efficacy in patients with breast cancer ( Mozafari-Motlagh et al, 2019 ), reducing anxiety, depression and fatigue while improving sleep quality and hope in patients with multiple sclerosis ( Pouyanfard et al, 2020 ), reducing body image-related distress and improving emotion regulation in cancer survivors following mastectomy ( Rasouli et al, 2023 ), reducing substance addiction compared to established treatment ( Wickham, 2013 ), and reducing sports-anxiety and pessimism and increasing flow and adherence in competitive athletes ( Scott-Hamilton et al, 2016 ).…”