Can Mindfulness Help with Glycemic Control in Adults with Diabetes?
Can Mindfulness Help with Glycemic Control in Adults with Diabetes?
— By Dawn M. Sweet, Ph.D.
Mindfulness could complement diet, exercise, and pharmacological therapies when treating patients with type 2 diabetes.
Managing diabetes requires a combination of several approaches that include diet, exercise, and medication. One overlooked or not-frequently-thought-of intervention is mindfulness. Mindfulness has been a successful stress-management technique1, and as such could help patients with diabetes manage diabetes distress. It could also help adults with diabetes lower their HbA1c levels. Though not a traditional intervention, mindfulness could complement traditional management strategies like diet and exercise as part of treatment plan.
Diabetes Distress
Patients with diabetes can experience diabetes distress, the emotional distress associated with a diabetes diagnosis and the stress associated with its daily management and treatment. Because diabetes is as chronic health condition that requires patients to continually monitor their blood glucose and be vigilant about dietary choices, patients can experience “diabetes burnout” which could lead to stress. To be clear, diabetes distress is not a psychopathology; it is a direct reaction to living with diabetes. Diabetes distress is associated with an elevated HbA1C, more frequent and severe and hypoglycemia, each of which is problematic.2
During the stress response, the sympathetic nervous system is activated. Under stress, cortisol and adrenaline can lead to insulin resistance, which results in blood sugar levels rising. Because stress negatively affects insulin, it is important to activate the parasympathetic nervous system so the body is no longer in the alert — “fight, flight or freeze” — response, and stress hormone production, heart rate and respiration return to normal levels.
Mindfulness and Managing Diabetes Distress
Recent research now suggests that mindfulness can help patients with diabetes lower their HbA1c.3 In a recent meta-analysis (n = 11 studies; n = 741 participants)4, Mindfulness Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Behavioral Therapy (MBCT) was shown to improve HbA1c. In another meta-analysis (n = 8 studies; n = 841 participants), a mindfulness-based intervention was found to slightly improve HbA1c (HbA1c; -0.25 percent) and diabetes distress. Five studies in this meta-analysis4 looked at diabetes distress and pooled results that showed a statistically significant reduction (MD -5,81, 95% CI -10.10 to 1.52; p = 0.008).
Another meta-analysis5 investigated the effects of mediation in adults with type 2 diabetes (n = 10; n = 698 participants). Again, MBSR and MBCT improved H1C levels with an effect size of -0.75 and a mean difference in HbA1c levels of -0.73 ± 0.63 percent in the intervention group and -0.12 ± 0.28 percent in the control group. It should be noted that in this study there was high heterogeneity between the studies included (I2 = 93.2 percent).
Although the results are promising, it should be noted that in a meta-analysis of four RCTS (n = 322), a beneficial effect of mindfulness was not found. The interventions were MBSR and a mindful eating practice. There was no effect on HbA1c levels.
Meditation for Diabetes: Implications for Clinical Practice
Stress is a part of living with diabetes, and because high stress levels can negatively affect HbA1c levels, it is important for health care professionals to consider all available strategies to help patients with diabetes manage their blood glucose levels. Although research does suggest a mindfulness intervention can help reduce HbA1c levels, more research is needed.
Developing a daily meditation practice could help patients manage stress. Working with patients to identify community programs and resources could help them jumpstart their mindfulness practice. Some mindfulness options to consider for patients with diabetes include body scans, mindful eating, and breathing exercise. Of course, adding physical activity and building better sleep habits could also help patients manage stress.
In addition to traditional treatment options for patients with diabetes, health care providers should consider working collaboratively with patients to implement sustainable lifestyle changes to help them achieve long-term, sustainable weight loss. Part of this treatment program could include Low Calorie (LCD) or Very Low Calorie Diets (VLCD) supported with scientifically formulated meal replacements to ensure nutritional needs are being met.
Source(s):
1 Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses
2 Diabetes Distress
3 The effects of Mindfulness on glycemic control in people with diabetes: An overview of systematic reviews and meta-analyses
4 Effects of mindfulness-based stress reduction and mindfulness-based cognitive therapy in people with diabetes: A systematic review and meta-analysis
5 Effects of meditation intervention on self-management in adult patients with type 2 diabetes: A systematic literature review and meta-analysis
About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.
About Robard: Robard Corporation’s medical obesity treatment programs and scientifically-designed nutrition products have been utilized by physicians, surgeons and hospitals across the United States to successfully treat patients living with obesity. To learn more about us and how we can help your practice and patients, visit us online at www.Robard.com, email us at info@robard.com, or call (800) 222-9201.
