Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: A pilot study

Department of Emergency Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Alternative therapies in health and medicine (Impact Factor: 1.14). 11/2006; 13(5):36-8.
Source: PubMed

ABSTRACT Psychological distress is linked with impaired glycemic control among diabetics.
Estimate changes in glycemic control, weight, blood pressure, and stress-related psychological symptoms in patients with type 2 diabetes participating in a standard Mindfulness Based Stress Reduction (MBSR) program.
Prospective, observational study.
Academic health center.
Adult patients with type 2 diabetes mellitus.
Participation in MBSR program for heterogeneous patient population. Diet and exercise regimens held constant.
Glycosylated hemoglobin A1c (HA1c), blood pressure, body weight, and Symptom Checklist 90-Revised (anxiety, depression, somatization, and general psychological distress scores).
Eleven of 14 patients completed the intervention. At 1 month follow-up, HA1c was reduced by 0.48% (P = .03), and mean arterial pressure was reduced by 6 mmHg (P = .009). Body weight did not change. A decrease in measures of depression, anxiety, and general psychological distress was observed.

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Available from: Jeffrey Greeson, Aug 15, 2015
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    • "Even though a consensus about an unequivocal operational definition of mindfulness is lacking so far [12] [13], one of most commonly employed definitions of mindfulness was provided by Jon Kabat-Zinn who suggests that mindfulness could be described as a moment to moment awareness that is cultivated by purposefully paying attention to the present experience, with a non-judgmental attitude [14]. Interventions utilizing mindfulness techniques have shown efficacy for treating a variety of mental disorders and in coping with physical or medical conditions, including, among others, chronic pain [15], fatigue [16], stress [17] [18], cancer [19], heart disease [20], type 2 diabetes [21], psoriasis [22], and insomnia [23]. Mindfulness-based stress reduction (MBSR) [24] is a well-established mindfulness training that has shown to reduce stress, depression, and anxiety [25] [26]. "
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    ABSTRACT: An increasing number of mindfulness-based stress reduction (MBSR) studies are being conducted with nonclinical populations, but very little is known about their effectiveness. To evaluate the efficacy, mechanisms of actions, and moderators of MBSR for nonclinical populations. A systematic review of studies published in English journals in Medline, CINAHL or Alt HealthWatch from the first available date until September 19, 2014. Any quantitative study that used MBSR as an intervention, that was conducted with healthy adults, and that investigated stress or anxiety. A total of 29 studies (n=2668) were included. Effect-size estimates suggested that MBSR is moderately effective in pre-post analyses (n=26; Hedge's g=.55; 95% CI [.44, .66], p<.00001) and in between group analyses (n=18; Hedge's g=.53; 95% CI [.41, .64], p<.00001). The obtained results were maintained at an average of 19weeks of follow-up. Results suggested large effects on stress, moderate effects on anxiety, depression, distress, and quality of life, and small effects on burnout. When combined, changes in mindfulness and compassion measures correlated with changes in clinical measures at post-treatment and at follow-up. However, heterogeneity was high, probably due to differences in the study design, the implemented protocol, and the assessed outcomes. MBSR is moderately effective in reducing stress, depression, anxiety and distress and in ameliorating the quality of life of healthy individuals; however, more research is warranted to identify the most effective elements of MBSR. Copyright © 2015 Elsevier Inc. All rights reserved.
    Journal of Psychosomatic Research 03/2015; DOI:10.1016/j.jpsychores.2015.03.009 · 2.84 Impact Factor
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    • "L. Shapiro, Schwartz, & Santerre, 2005). Some of the study samples were small (Davis, Fleming, Bonus, & Baker, 2007; Astin, 1997; Cohen-Katz et al., 2005; Goldin & Gross, 2010; Rosenzweig et al., 2007), some did not have an appropriately matched control group or no-treatment group (Tacón et al., 2003; Carlson & Garland, 2005; Beddoe & Murphy, 2004), and most did not follow participants after the program ended. Additionally, because MBSR is a therapeutic package, the research is not capable of assessing the impact of each of its components on its own. "
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    ABSTRACT: The literature on mindfulness has been dominated by the two leading schools of thought: one advanced by Langer and her colleagues; the other developed by Kabat-Zinn and his associates. Curiously, the two strands of research have been running in parallel lines for more than 30 years, scarcely addressing each others’ work, and with almost no attempt to clarify the relationship between them. In view of this gap, this article sought to systematically compare and contrast the two lines of research. The comparison between the two schools of thought suggests that although there are some similarities in their definitions of mindfulness, they differ in several core aspects: their philosophies, the components of their constructs, their goals, their theoretical scope, their measurement tools, their conceptual focus, their target audiences, the interventions they employ, the mechanisms underlying these interventions, and the outcomes of their interventions. However, the analysis also revealed that self-regulation is a core mechanism in both perspectives, which seems to mediate the impact of their interventions. In view of the differences between the two strands of research, we propose that they be given different titles that capture their prime features. We suggest “creative mindfulness” for Langer and her colleagues’ scholarship, and “meditative mindfulness” for Kabat-Zinn and his associates’ scholarly work.
    Review of General Psychology 10/2013; 17(4):453-466. DOI:10.1037/a0035212 · 1.78 Impact Factor
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    • "MBCT has been designed as a method to prevent recurrence of depression in patients with prior history of depressive disorder (Segal et al., 2002), yet, there is increasing evidence that MBCT is also effective in the treatment of current depressive symptoms (Hofmann et al., 2010). Among patients with diabetes, only five studies (two observational trials and three randomized controlled trials) have been conducted so far testing the effectiveness of mindfulness-based interventions, showing decreases in psychological distress (Hartmann et al., 2012; Rosenzweig et al., 2007; Schroevers et al., 2013; van Son et al., 2013; Young et al., 2009). A recent randomized controlled trial investigating the effect of MBCT for patients with diabetes found a greater reduction of depressive symptoms in the mindfulness group compared to the waiting list control condition (van Son et al., 2013). "
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    ABSTRACT: Background Depressive symptoms are a common problem in patients with diabetes, laying an additional burden on both the patients and the health care system. Patients suffering from these symptoms rarely receive adequate evidence-based psychological help as part of routine clinical care. Offering brief evidence-based treatments aimed at alleviating depressive symptoms could improve patients’ medical and psychological outcomes. However, well-designed trials focusing on the effectiveness of psychological treatments for depressive symptoms in patients with diabetes are scarce. The Mood Enhancement Therapy Intervention Study (METIS) tests the effectiveness of two treatment protocols in patients with diabetes. Individually administered Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Cognitive Therapy (MBCT) are compared with a waiting list control condition in terms of their effectiveness in reducing the severity of depressive symptoms. Furthermore, we explore several potential moderators and mediators of change underlying treatment effectiveness, as well as the role of common factors and treatment integrity. Methods/design The METIS trial has a randomized controlled design with three arms, comparing CBT and MBCT with a waiting list control condition. Intervention groups receive treatment immediately; the waiting list control group receives treatment three months later. Both treatments are individually delivered in 8 sessions of 45 to 60 minutes by trained therapists. Primary outcome is severity of depressive symptoms. Anxiety, well-being, diabetes-related distress, HbA1c levels, and intersession changes in mood are assessed as secondary outcomes. Assessments are held at pre-treatment, several time points during treatment, at post-treatment, and at 3-months and 9-months follow-up. The study has been approved by a medical ethical committee. Discussion Both CBT and MBCT are expected to help improve depressive symptoms in patients with diabetes. If MBCT is at least equally effective as CBT, MBCT can be established as an alternative approach to CBT for treating depressive symptoms in patients with diabetes. By analyzing moderators and mediators of change, more information can be gathered for whom and why CBT and MBCT are effective. Trial registration Clinical Trials NCT01630512.
    10/2013; 1(1). DOI:10.1186/2050-7283-1-17
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