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Efficacy of acceptance and commitment therapy for people with type 2 diabetes: Systematic review and meta-analysis

Ryo Sakamoto1, Yoichi Ohtake2,3, Yuki Kataoka4,5,6,7

  • 1Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osakasayama, Japan.

Journal of Diabetes Investigation
|September 6, 2021
PubMed
Abstract

Insights

Acceptance and Commitment Therapy (ACT) may improve type 2 diabetes management by reducing glycated hemoglobin and enhancing self-care abilities. This therapy also increases patient acceptance, supporting better health outcomes in individuals with type 2 diabetes mellitus.

Area of Science:

  • Behavioral Psychology
  • Endocrinology
  • Clinical Psychology

Background:

  • Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder requiring comprehensive management strategies.
  • Psychological interventions are increasingly recognized for their role in improving T2DM self-management and clinical outcomes.
  • Acceptance and Commitment Therapy (ACT) is a mindfulness-based behavioral intervention that promotes psychological flexibility.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy and safety of ACT in individuals diagnosed with type 2 diabetes mellitus.
  • To evaluate ACT's impact on key glycemic control markers, self-care behaviors, and psychological acceptance in T2DM patients.

Main Methods:

  • A systematic literature search was conducted across major electronic databases (PubMed, CENTRAL, PsycINFO, etc.) up to January 16, 2021.
  • Randomized controlled trials comparing ACT with usual care for T2DM were included, irrespective of language.
  • Primary outcomes included glycated hemoglobin (HbA1c), diabetes self-care activities, and adverse events; acceptance was a secondary outcome.

Main Results:

  • Meta-analysis of three trials revealed that ACT significantly reduced glycated hemoglobin levels (MD -0.62; 95% CI -1.07 to -0.16) with low-quality evidence.
  • ACT demonstrated a significant improvement in diabetes self-care activities scores (MD 8.48; 95% CI 2.16-14.80) based on high-quality evidence.
  • Acceptance, measured by the Acceptance and Action Diabetes Questionnaire, significantly increased (MD 5.98; 95% CI 1.42-10.54) with low-quality evidence.

Conclusions:

  • ACT shows potential as an effective intervention for improving glycemic control in type 2 diabetes.
  • The therapy enhances self-care abilities and psychological acceptance, crucial components for managing T2DM.
  • Further research with high-quality evidence is warranted to confirm the safety and long-term benefits of ACT in T2DM management.
Keywords:
Acceptance and commitment therapyMeta-analysisType 2 diabetes

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