Effects of Mindfulness-Based Stress Reduction on Insulin-Treated Diabetes
Raquel Rein, Meghan M. Searl, Shreya Bhandari, Kathryn E. Cote, Isra Hashmi, Kayla L. del Valle, Marie Elizabeth McDonnell
Diabetes June 22, 2018 DOI: 10.2337/db18-857-p (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Nonrandomized pilot feasibility study Peer reviewed |
|---|---|
| Sample size | 10 |
| Population | Insulin-treated adults with uncontrolled type 1 or type 2 diabetes (mean age 50.8 years; 60% female; 100% white non-Hispanic; mean baseline A1c 8.6%; mean diabetes duration 14 years; 30% T1D, 70% T2D) |
| Intervention | Mindfulness Based Stress Reduction (MBSR) |
| Duration | 8-week program; assessments at baseline, 3 months, and 6 months post intervention |
| Measures | Diabetes Distress Scale (DDS), Problem Areas in Diabetes (PAID), A1c |
| Topics | Meditation |
| Citations | 2 |
| Key points | All nine participants who completed the MBSR program had reduced total diabetes distress scores, with significant drops in emotional and regimen-related distress (-1.2 each). Mean A1c fell by 0.4% at 6 months, and PAID score reduction correlated with A1c reduction (r=0.5). The authors suggest a larger trial is needed to test broader accessibility and cost-effectiveness. |
Abstract
Patients with type 1 (T1D) and type 2 diabetes (T2D) on insulin experience significant diabetes related distress (DD) which is known to negatively impact overall health and ability to self-manage the disease. Mindfulness Based Stress Reduction (MBSR) is an 8-week in-person group-taught program that has been shown to be effective in improving outcomes in chronic diseases. However, MBSR research in diabetes has been limited and has not included complex diabetes. We hypothesized that MBSR would lower DD and improve glycemic control in patients with uncontrolled insulin-treated diabetes. We conducted a nonrandomized pilot feasibility study of MBSR in insulin-treated patients with A1c above goal. Subjects completed the Diabetes Distress Scale (DDS) and Problem Areas in Diabetes (PAID) surveys at baseline, 3 months, and 6 months post intervention. Of 335 patients screened, 10 were enrolled. Patient characteristics included mean age 50.8 years; 60% female; 100% white non-Hispanic; mean baseline A1c= 8.6% +/-0.8. Duration of diabetes was 14 years +/-9; 30% T1D, 70% T2D; 100% on insulin; 70% injected insulin at least 3 times per day. Subjects attended 26 hours of in-class contact. Nine subjects completed the study; one was excluded due to interim pregnancy. All had decreased total DDS scores. There were statistically significant reductions in two DDS domains: emotional (-1.2, p=0.01) and regimen-related distress (-1.2, p=0.004). At 6 months, the mean A1c reduction was -0.4% +/- 0.9. The reduction in PAID score correlated with A1c reduction (r= 0.5). In conclusion, uncontrolled insulin treated diabetes patients who participated in MBSR experienced a sustainable improvement in emotional and regimen-related distress which was accompanied by lower A1c. Results suggest the need for a large clinical trial designed to optimize accessibility to a broader population of patients and to test the cost-effectiveness of this nonpharmacologic intervention. Disclosure R. Rein: None. M. Searl: None. S. Bhandari: None. K.E. Cote: None. I. Hashmi: None. K.L. Del Valle: None. M.E. McDonnell: None.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |