Background: Type 2 diabetes (T2D) is a chronic metabolic disorder that has a significant impact on the mental health of an individual, which in turn results in increased morbidity and mortality.

Objective: To evaluate the effect of holistic lifestyle intervention in improving mental health outcomes in patients with T2D. Materials and

Methods: In this quasi-experimental study, baseline data (anthropometry and medical history) on 428 T2D patients enrolled in a one-year online holistic lifestyle intervention program at the Freedom from Diabetes Clinic (Pune, India) between May 2021 and Feb 2022 were collected. The validated Patient Health Questionnaire (PHQ-9) (scoring 0-27) and Generalized Anxiety Disorder Assessment (GAD-7) scale (scoring 0-21) were used to assess depression and anxiety, respectively. The intervention included a customized vegan diet and exercise protocol along with stress-relieving group sessions for diabetes management and one-on-one psychological counselling sessions (aimed specifically at people with anxiety and/or depression). After 6 months of intervention, the questionnaires were re-administered to assess the reduction in anxiety and depression.

Results: The prevalence of depression, anxiety, and both was 7.9%, 7.2%, and 8.9% at baseline, respectively. Post-intervention, it reduced to 3.5%, 3.7%, and 4.9%, respectively. The absolute change (calculated as final score-initial score/initial score*100) was significantly higher for both depression and anxiety scores in those who received the intervention (group therapy or individual counselling) vs those who chose not to receive the intervention (p<0.05). Of the 72 and 69 patients who showed depression and anxiety at baseline, 43 and 40 shifted to the minimal to mild categories, respectively, indicating improvement.

Conclusion: Our findings suggest that incorporating a psychological component into lifestyle interventions may help improve mental health in patients with T2D.

Disclosure

P.Tripathi: Board Member; Freedom from Diabetes Clinic. N.S.Kadam: Research Support; Freedom from Diabetes Clinic. B.Sharma: Research Support; Freedom From Diabetes clinic. A.R.Vyawahare: Research Support; Freedom From Diabetes. M.Das biswas: Employee; Freedom from Diabetes Clinic. M.H.Ganla: Employee; Freedom from Diabetes Clinic. B.D.Saboo: None.

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