Mindfulness Training Lowers Diabetes-Related Distress and HbA1c in US Veterans

Summary

A small study has indicated the effectiveness of mindfulness meditation—the nonjudgmental focus on the present moment-in lessening diabetes-related distress in US veterans with diabetes and in lowering HbA1c throughout 3 months.

  • Hyperglycemia/Hypoglycemia
  • Diabetes Mellitus
  • Diabetes & Endocrinology Clinical Trials Diabetes & Metabolic Syndrome
  • Hyperglycemia/Hypoglycemia
  • Diabetes Mellitus
  • Diabetes & Endocrinology Clinical Trials
  • Endocrinology
  • Diabetes & Metabolic Syndrome

A small study has indicated the effectiveness of mindfulness meditation—the nonjudgmental focus on the present moment—in lessening diabetes-related distress in US veterans with diabetes and in lowering HbA1c throughout 3 months. Monica DiNardo, PhD, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA, presented the results of this study.

Of the 4 million veterans registered in the Veterans Health Administration, 25% are diagnosed with diabetes [US Department of Veteran Affairs. QUERI-Quality Enhancement Research Initiative 2014]. Diabetes-related distress can detract from the self-management of the disease, resulting in depression and diminished control of blood glucose. Health assistance efforts by the 125 Veterans Administration centers across the United States include complementary and alternative medicine programs or referrals. These centers, however, are used mainly for pain control and posttraumatic stress disorder. Resources are limited for inclusion of the large number of veterans with diabetes, so diabetes-related distress is not currently being addressed.

Dr. DiNardo and her colleagues noted the absence of studies concerning mindfulness meditation for diabetes-related distress in US veterans. The present study, Mindfulness Stress Reduction in Diabetes Education [Mind-STRIDE], assessed the feasibility of a brief (90- minute) meditation-based intervention on 28 veterans. The veterans included in the study had both type 1 (n = 6; 21.4%) and type 2 (n = 22; 78.6%) diabetes, with a duration of diabetes of 18.2 years (range, .5 to 55 years). The participants' diabetes medication regimen had not changed for at least the previous month.

In the mindfulness training, participants learned techniques to reduce stress through practical methods, such as focused breathing and mindful movement. The initial intervention session consisted of a group discussion focusing on how to live with diabetes, training on how to perform mindfulness meditation, and tips and skills for continuing meditation at home (Table 1).

Table 1.

Aspects of Mindfulness Meditation

The participants were given a diary and a CD for home practice. They were asked to spend 10 to 15 minutes, 5 or 6 days a week for 3 months practicing at home. Table 2 summarizes evaluations completed prior to the intervention session, 1 month later at the time of a booster intervention session, and 2 months after that.

Table 2.

Pre- and Postintervention Measures

The 28 veterans had a mean age of 62.8 years (range, 40 to 76 years). The majority (n = 19; 68%) were Caucasian, and nearly all (n = 27; 96%) were men. Body mass index was 33.2 ± 7.04 kg/m2, and the HbA1c level was 8.35 (± 1.60). Of the 28 individuals, 20 (71%) completed the 3-month study, with 11 (39%) maintaining the diary throughout their participation.

Diabetes-related distress decreased by about 19% at 1 month (p < .01) and 41% at 3 months (p < .01). Awareness, coping, self-management, and self-care scores increased throughout the 3-month study, with the latter 2 scores being significantly greater at 3 months than prior to the first intervention (p < .01 for both). Baseline and 3-month HbA1c data were 8.4% and 7.3%, respectively, which was a significant decrease (p < .01).

Study limitations include the small number of subjects and an uncontrolled design. Although the results cannot be generalized, the study establishes the feasibility of mindfulness meditation in easing diabetes-related distress. Larger controlled studies using real-time recording of daily meditation sessions are needed.

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