Mental health disorders like depression and anxiety are highly prevalent in people with diabetes and are associated with poorer outcomes. The current study investigated the effect of a novel online cognitive behavioural therapy (CBT) based intervention derived from Acceptance and Commitment Therapy (ACT) for people with type 2 diabetes. A total of 102 patients with type 2 diabetes and a concomitant mental health disorder completed a course of the novel CBT-based intervention, delivered one-to-one over the internet, using text, by therapists who were specially trained in diabetes. Patients showed pre-treatment scores indicative of moderate to severe depression and anxiety and clinically significant diabetes distress. The treatment paradigm caused statistically significant and clinically meaningful decreases in depression, anxiety and diabetes distress scores. Changes in patient activation further illustrated the degree of improvement seen, with the proportion of patients at the lowest level of activation decreasing from 44.1% to 23.5%, pre- to post-treatment, and half of patients increasing by at least one level of activation. Comparisons between the study group and different synthetic control groups, derived from real-world data obtained using the same online platform as used for the trial, underlined the marked improvements achieved - recovery rates of 76% in the study group compared to 56% and 68% in the synthetic control arms. This study demonstrates that this novel CBT-based treatment, delivered by therapists who have specialism in the disease, provides an integrated therapy which can deliver substantial clinical benefit to patients with diabetes and comorbid mental health problems. Moreover, because it is delivered online, it can be given at a time and place that is convenient to both patients and therapists.
A. G. Hayes: Consultant; Ieso Digital Health Ltd. A. Catarino: Employee; ieso. S. Mehew: None. A. Blackwell: Employee; IESO.
Roche Diabetes Care Limited