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

A systematic review and meta-analysis of nine randomized controlled trials found that mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) significantly improved depression, the mental health composite score of quality of life, and glycosylated hemoglobin (HbA1c) in people with type 1 and type 2 diabetes. The analysis showed a large effect on depression reduction and clinically meaningful improvements in mental health-related quality of life and glycemic control. No significant effect was found on the physical health composite score of quality of life. The authors conclude that MBSR and MBCT are beneficial complementary treatments for diabetes, though more trials with longer follow-up are needed.

Study at a glance

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.