1605-P: Synchronous Video-Conference–Based Mindfulness-Based Stress Reduction vs. Stress Management Education for Uncontrolled Diabetes: A Randomized Trial
Nazia Raja-Khan, Allen R Kunselman, Emily Wasserman, Jeffrey M Greeson, Donald A. Mccown
Diabetes June 5, 2026 DOI: 10.2337/db26-1605-p (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 309 |
| Population | Adults aged 18 years or older with diabetes and elevated stress |
| Intervention | Stress Management Education (SME) |
| Duration | 6 months |
| Measures | HbA1c (A1CNow), Perceived Stress Scale (PSS-10), diabetes distress |
| Topics | Meditation |
| Key findings | Mindfulness-Based Stress Reduction delivered by video conference did not improve HbA1c more than an active stress-management education control; HbA1c decreased by about 0.35% in both groups at six months. MBSR produced a greater reduction in perceived stress at two months (3.2 vs 1.6 points on the PSS-10), but this difference was not significant at six months, and diabetes distress improved similarly in both groups. |
Abstract
Introduction and
Objective: Adults with diabetes often experience high stress that can impair self-management and glycemia. We tested whether video-conference-based mindfulness meditation training (Mindfulness-Based Stress Reduction [MBSR]) improves HbA1c compared with an active Stress Management Education (SME) control in adults with uncontrolled diabetes.
Methods: Randomized trial. Adults (≥18 years) with diabetes and elevated stress were randomized to synchronous video-conference-based MBSR or SME with parallel schedules and assigned home practice. The primary outcome was change in home HbA1c (A1CNow) from baseline to 6 months, analyzed using a linear mixed-effects model (fixed effects: arm, visit, baseline insulin use, arm × visit interaction; random effects: participant and cohort).
Results: A total of 309 participants were randomized (MBSR n=154; SME n=155); mean age was 54.6 ± 12 years and 67% were female. Baseline HbA1c mean was 8.50% (95% CI 8.23 to 8.77) in MBSR and 8.60% (8.33 to 8.87) in SME. At 6 months, HbA1c decreased in both groups: −0.35% (−0.60 to −0.10) with MBSR and −0.36% (−0.60 to −0.11) with SME; difference in changes (SME−MBSR) −0.01% (−0.36 to 0.34), p=0.96. Perceived stress (PSS-10) decreased more with MBSR than SME from baseline to 2 months: −3.2 (−4.3 to −2.1) vs −1.6 (−2.7 to −0.6); difference in changes 1.6 (0.1 to 3.1), p=0.04; at 6 months, changes were −2.8 (−3.9 to −1.7) vs −2.0 (−3.1 to −0.9); difference in changes 0.8 (−0.7 to 2.4), p=0.30. Diabetes distress improved between baseline and 6 months: −0.34 (−0.47 to −0.22) vs −0.39 (−0.51 to −0.27); difference in changes −0.05 (−0.22 to 0.12), p=0.59.
Conclusion: Synchronous video-conference-based mindfulness meditation training (MBSR) did not differentially improve HbA1c compared with an active control, but produced greater reductions in perceived stress. These findings inform scalable approaches to stress in adults with diabetes and support future work exploring mechanisms linking stress reduction and metabolic outcomes. Disclosure N. Raja-Khan: None. A. Kunselman: Stock/Shareholder; Current; Merck & Co., Inc. E. Wasserman: None. J. Greeson: None. D.A. McCown: None.
Funding: National Institutes of Health (R01 DK119379)
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |