Incorporating Complementary Therapies Into Diabetes Care

Current diabetes care and education programs and expert clinical diabetes management guidelines focus on diabetes self-care behaviors and have yet to incorporate complementary therapies. Complementary therapies, such as music therapy, yoga, mindfulness, and art therapy, have been used globally for centuries and have positive metabolic and glycemic outcomes. In this mini-review, we describe complementary therapies successfully used in diabetes, identify current evidence-based practice gaps, and provide recommendations for incorporating complementary therapies into diabetes care.

We thoroughly searched relevant PubMed and Google Scholar studies from 2004 to 2024. Our inclusion criteria were clinical trial studies using the search terms "diabetes self-management" OR "metabolic outcomes" OR "diabetes" OR "type of complementary therapy (music therapy, mindfulness, yoga or art therapy) OR population (type 1 diabetes, type 2 diabetes, prediabetes, diabetes)."

We synthesized the evidence to determine complementary therapies (music therapy, mindfulness, yoga, or art therapy) that benefit individuals with diabetes. Findings showed that complementary therapies support diabetes-related psychological and cardiometabolic outcomes and enhance the Association of Diabetes Care and Education Specialists 7 Self-Care Behaviors for diabetes self-management, specifically healthy coping, monitoring, reducing risks, and problem-solving. Critical gaps included the lack of large-scale randomized controlled trials in North American diabetes self-management education programs.

Complementary therapies have positive psychological and physiological health benefits for people living with diabetes, yet more randomized controlled trials are needed to assess their effectiveness on a large scale. In the interim, complementary therapies can be integrated into diabetes education, specifically as adjunctive hands-on therapies to enhance self-management behaviors and meet self-management goals.