Diabetes

Diabetes impacts about 7% of the North American population, and is due to the body’s inability to sufficiently produce and/or properly use insulin. It is characterized by symptoms of fatigue, lack of energy, frequent infections, easy bruising, tingling and pain in extremities, and weight changes (Public Health Agency of Canada 2012). A number of studies have been reported recently, many of which have monitored biomarkers as well as psychological functioning. Two earlier studies compared MBIs to educational control conditions in RCTs (Teix- eira 2010) and reported greater improvements in QL related to pain and symptoms, adaptive coping, and better self-care behaviors in the MBI condition, as well as glycosylated hemoglobin (Hb) A1c values (a marker of blood glucose control) in the target range.

In a large ongoing study (Hartmann et al. 2012), 110 patients with type II diabetes were assigned to either MBSR or a usual care control condition. The MBSR participants improved more on overall health status, depression, and stress symptoms relative to controls after one year. Participants will be followed for a full five years post-treatment. Another large study compared MBCT to usual care in 139 diabetes patients (van Son et al. 2013) and found the intervention superior to control for decreasing stress, depressive symptoms, anxiety, and improving quality of life, but not on HbA1c.

A recent RCT evaluated a three-month mindful eating intervention compared to diabetes self-management in 52 patients (Miller et al. 2014), a much tougher test of differential efficacy against an active intervention group. Both groups improved over the course of six months on measures of depression, nutrition and eating-related self-efficacy, and cognitive control of eating, but the self-management group improved more on specific nutrition knowledge and self-efficacy, as well as fruit and vegetable consumption. The mindfulness group showed greater improvement on measures of mindfulness.

Thus, there is initial evidence that MBIs can be beneficial for improving psychological functioning and possibly improving glycemic control and helping with the neuropathy associated with type II diabetes. However, MBIs have only been shown to be superior to usual care or education control at this point, with the one study comparing an MBI to self-management showing few differential effects. Studies are still few in number and much more work needs to be done in this area.

 
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