Effect of mindfulness-based intervention in patients with diabetes: a meta-analytic review

Traditional management strategies for diabetes primarily focus on behavioural risk factors and pharmacological therapies. Furthermore, mindfulness-based interventions (MBIs) aim to assist patients in recognising and accepting sensations, emotions and cognitions without automatic reactivity. This approach can potentially enhance glycaemic control and mental health in diabetic patients. This systematic review and meta-analysis aim to assess the effects of MBIs among individuals diagnosed with diabetes.

A systematic literature search and meta-analysis were conducted following international quality standards utilised by the Cochrane Collaboration. Randomised controlled trials were included. The population of interest was defined as any patient diagnosed with diabetes; MBIs were defined as the intervention. Pubmed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and Lilacs were accessed. A grey literature search was performed using OpenGrey and ClinicalTrials tools. Outcomes included changes in glycosylated haemoglobin percentage (%HbA1c), depression, and stress scores. The risk of bias was assessed using the RoB 2 tool, and publication bias was evaluated through Egger's test. The results were presented with forest plots. The mean difference (MD) for the %HbA1c and the standardised MD for the measurement scale scores were used as effect measures.

The initial search retrieved 442 scientific articles, 11 randomised clinical trials were finally selected for the systematic review, which included 987 participants (487 in the intervention groups), and seven articles were included in the meta-analysis. The meta-analysis showed that MBIs had effects at follow-up (between 12 and 20 weeks) in reducing %HbA1c levels (MD = -0.5, CI 95% [-0.67, -0.34]) and depression SMD = -0.84, CI 95% [-1.11, -0.56]).

It is proposed that mindfulness significantly enhances mental health and glycaemic control in patients with diabetes. Further research is warranted to confirm these effects and gain a deeper understanding of the contribution of MBIs in comprehensive diabetes treatment.