The Effect of Cognitive Behavioral Therapy on Diabetes Distress Score and Glycemic Control in Patients with Type-II Diabetes Mellitus: A Prospective Case-Control Study CBT Impact on Diabetes Distress and Glycemic Control
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Abstract
Background: Type-II Diabetes Mellitus (T2DM) is a chronic metabolic disorder associated with insulin resistance and hyperglycemia, leading to significant complications. Diabetes Distress, a psychological stressor, negatively impacts self-management and glycemic control in T2DM patients. Cognitive Behavioral Therapy (CBT) has been recognized for its effectiveness in managing psychological issues but its impact on Diabetes Distress and glycemic control remains under-researched.
Objective: To evaluate the effect of CBT on Diabetes Distress Score and glycemic control (HbA1c) in patients with T2DM.
Methods: This prospective case-control study included 82 patients with T2DM (CBT group = 40, Control group = 42). The CBT group underwent a 10-session structured CBT intervention, while the control group received standard care. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up using Diabetes Distress Scale (DDS) and HbA1c levels. Data were analyzed using repeated measures ANOVA and t-tests.
Results: The CBT group showed a significant reduction in DDS (-0.8 ± 0.4, p < 0.001) compared to the control group (-0.2 ± 0.3, p = 0.078). HbA1c levels decreased significantly in the CBT group (-0.7 ± 0.3, p < 0.01) versus the control group (-0.2 ± 0.2, p = 0.083).
Conclusion: CBT effectively reduces Diabetes Distress and improves glycemic control in T2DM patients, supporting its integration into routine diabetes management.
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References
Lesley DL, Lutes PhD. A Tailored Cognitive-Behavioural Intervention Produces Comparable Reductions in Regimen-Related Distress in Adults with Type 2 Diabetes Regardless of Insulin Use: 12-Month Outcomes from the COMRADE Trial. Canadian Journal of Diabetes. 2020;44(6):530-6.
Zuo X. Effects of Cognitive Behavioral Therapy on Sleep Disturbances and Quality of Life Among Adults with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Nutrition, Metabolism and Cardiovascular Diseases. 2020;30(11):1980-8.
Alahyari A. The Effectiveness of Cognitive Behavioral Group Intervention on Depression and Anxiety in Patients with Type II Diabetes. European Review of Applied Psychology. 2021;71(1):100624.
Fayed A. Relation Between Diabetes Related Distress and Glycemic Control: The Mediating Effect of Adherence to Treatment. Primary Care Diabetes. 2022;16(2):293-300.
Fatmawati. Development of Cognitive Behavior Therapy Apps Application on Depression Management in Patients of Diabetes Mellitus Type II. Enfermería Clínica. 2020;30(5):21-7.
Lerttrakarnnon P. Chapter 10 - Diabetes-Related Distress and HbA1c: The Use of Cognitive Behavioral Therapy. Handbook of Cognitive Behavioral Therapy by Disorder. 2023;105-19.
Verma I. The Impact of Peer Coach-Led Type 2 Diabetes Mellitus Interventions on Glycemic Control and Self-Management Outcomes: A Systematic Review and Meta-Analysis. Primary Care Diabetes. 2022;16(6):719-35.
Huang CY. Sleep Disturbances, Glycemic Control, Stress, and Coping Among Diabetic Patients: A Structural Equation Modelling Approach. Applied Nursing Research. 2023;70:151661.
Tanaka R. Diabetes Self-Management Education and Support for Adults with Newly Diagnosed Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Diabetes Research and Clinical Practice. 2020;169:108480.
Azadbakht M. The Prevalence and Predictors of Diabetes Distress in Elderly with Type 2 Diabetes Mellitus. Diabetes Research and Clinical Practice. 2020;163:108133.
Luo X. Effects of Baduanjin Exercise on Blood Glucose, Depression, and Anxiety Among Patients with Type II Diabetes and Emotional Disorders: A Meta-Analysis. Complementary Therapies in Clinical Practice. 2023;50:101702.
Langerman C. The Experiences of Insulin Use Among Older People with Type 2 Diabetes Mellitus: A Thematic Synthesis. Primary Care Diabetes. 2022;16(5):614-26.
Srisurapanont M. Antidepressants for Depressed Patients with Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-Analysis of Short-Term Randomized Controlled Trials. Neuroscience & Biobehavioral Reviews. 2022;139:104731.
Racaru MS. The Effects of Psychological Interventions on Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis. Pain Management Nursing. 2021;22(3):302-11.
Lim LL. Team-Based Multicomponent Care Improved and Sustained Glycemic Control in Obese People with Type 2 Diabetes in a Diabetes Center Setting: A Quality Improvement Program with Quasi-Experimental Design. Diabetes Research and Clinical Practice. 2022;194:110138.
Silveira-Rodrigues JG. Combined Exercise Training Improves Specific Domains of Cognitive Functions and Metabolic Markers in Middle-Aged and Older Adults with Type 2 Diabetes Mellitus. Diabetes Research and Clinical Practice. 2021;173:108700.
Kılıç A. A 12-Month Longitudinal Study Examining the Shared and Unique Contributions of Self-Compassion and Psychological Inflexibility to Distress and Quality of Life in People with Type 2 Diabetes. Journal of Psychosomatic Research. 2022;155:110728.
Alho I. Acceptance and Commitment Therapy Group Intervention for Adolescents with Type 1 Diabetes: A Randomized Controlled Trial. Journal of Contextual Behavioral Science. 2022;125:153-61.
Saha CK. Program ACTIVE II: 6- and 12-Month Outcomes of a Treatment Approach for Major Depressive Disorder in Adults with Type 2 Diabetes. Journal of Diabetes and Its Complications. 2024;38(2):108666.
Bilgin A. The Effect of Motivational Interviewing on Metabolic Control and Psychosocial Variables in Individuals Diagnosed with Diabetes: A Systematic Review and Meta-Analysis. Patient Education and Counseling. 2022;105(9):2806-23.
Roddy MK. Family Involvement and Diabetes Distress Across Dyads for Adults with Type 2 Diabetes. Patient Education and Counseling. 2023;112:107719.
Maina PM. Self-Management Practices for Preventing Complications of Type II Diabetes Mellitus in Low and Middle-Income Countries: A Scoping Review. International Journal of Nursing Studies Advances. 2005;3:100136.
Kunik ME. The Impact of Veteran Support and Resources for Diabetes (iNSPiRED) on Diabetes Distress: Results from a Randomized, Parallel-Group Trial. General Hospital Psychiatry. 2023;85:55-62.