Patients with diabetes have higher prevalence of depression and diabetes-related distress that negatively impacts care. Mindfulness-based approaches have shown to improve depression, diabetes-related distress, and in small studies also improve glycemic outcomes. We created a 90-minute, shared medical appointment; led by an endocrinologist, teaching patients integrative approaches to manage diabetes- related distress. We included patients with type 2 diabetes referred by a primary care provider or an endocrinologist, and assessed Diabetes Distress Scale (DDS), Patient Health Questionnaire-9 (PHQ-9) as well as Hemoglobin A1C (HbA1C), weight, blood pressure (BP), heart rate (HR) before the group visit.
Thirty-four patients attended group sessions, with mean age of 63.9 years, mean baseline HbA1C 7.7% and mean BMI 33.3. The mean DDS was 36.2, and mean PHQ-9 was 7.8. Twenty-four patients followed up in clinic 3 months after initial appointment and showed mean reduction in HbA1C by 0.18% (p=0.35). Subgroup analysis of patients with baseline HbA1C ≥ 7.5% (n=11) showed mean reduction in HbA1C by 0.8% (p=0.005). No statistically significant changes in BP, HR or weight were seen, while a subgroup of patients with baseline A1C ≥7.5% had non-statistically significant mean weight loss of 1.3kg. This retrospective study of a mindfulness-based approach suggests positive clinical impact and need for a larger, randomized trial.
| Table 1. Baseline characteristics, change in parameters 3 months after intervention | |||
| Baseline characteristics | Total patients who attended (N=34) | Patients with 3 months follow up (n=24) | Subgroup with baseline HbA1C ≥7.5 (n=11) |
| Mean age in years (SD) | 63.9 (10.2) | 65.2 (9.7) | 64.6 (10.9) |
| % Women | 67.60% | 66.70% | 72.70% |
| Mean body weight, kg (SD) | 94.3 (22.8) | 90.2 (16.6) | 91.7 (17.5) |
| Mean BMI (SD) | 33.3 (7.2) | 31.9 (5.54) | 31.8 (6.0) |
| Mean HgbA1C, % (SD) | 7.7 (1.3) | 7.5 (1.2) | 8.5 (0.9) |
| Mean DDS (SD) | 36.2 (13.7) | 35.7 (14.3) | 35.9 (15.8) |
| Mean PHQ-9 (SD) | 7.8 (5.2) | 7.4 (5.8) | 7.1 (6.7) |
| Change in HbA1C from baseline to 3 months | - 0.15 % (p=0.35) | - 0.8 % (p=0.005) | |
| Change in weight from baseline to 3 months | - 0.4 kg (p=0.48) | - 1.3kg (p=0.17) | |
| Table 1. Baseline characteristics, change in parameters 3 months after intervention | |||
| Baseline characteristics | Total patients who attended (N=34) | Patients with 3 months follow up (n=24) | Subgroup with baseline HbA1C ≥7.5 (n=11) |
| Mean age in years (SD) | 63.9 (10.2) | 65.2 (9.7) | 64.6 (10.9) |
| % Women | 67.60% | 66.70% | 72.70% |
| Mean body weight, kg (SD) | 94.3 (22.8) | 90.2 (16.6) | 91.7 (17.5) |
| Mean BMI (SD) | 33.3 (7.2) | 31.9 (5.54) | 31.8 (6.0) |
| Mean HgbA1C, % (SD) | 7.7 (1.3) | 7.5 (1.2) | 8.5 (0.9) |
| Mean DDS (SD) | 36.2 (13.7) | 35.7 (14.3) | 35.9 (15.8) |
| Mean PHQ-9 (SD) | 7.8 (5.2) | 7.4 (5.8) | 7.1 (6.7) |
| Change in HbA1C from baseline to 3 months | - 0.15 % (p=0.35) | - 0.8 % (p=0.005) | |
| Change in weight from baseline to 3 months | - 0.4 kg (p=0.48) | - 1.3kg (p=0.17) | |
J. Ku: None. M. Freeby: None. R.S. Mullur: None.
