PHILADELPHIA – Eight weeks of training classes in mindfulness-based stress reduction plus at-home meditation sessions led to medium to large improvements in mindfulness, stress, and diabetes problems in a pilot study that enrolled six women with type 2 diabetes who were on oral medications.
The mindfulness stress-reduction program also was linked with an average 0.7% cut in hemoglobin A1c (HbA1c) levels in the six women who participated in the intervention, Monica DiNardo said at the annual meeting of the American Association of Diabetes Educators.
Based on these "encouraging" results in the pilot study, Ms. DiNardo, a nurse practitioner at the Veterans Affairs Medical Center in Pittsburgh, and her associates began a similar mindfulness intervention in 28 patients with diabetes treated there in a study that also included 7 control patients who did not undergo the intervention. Follow-up data from many of these patients will soon be analyzed, she said.
Mitchel L. Zoler/IMNG Medical Media
Monica DiNardo
Results available so far also show that in the pilot study, as well as the study with 35 veterans, the mindfulness stress-reduction training and home-based sessions were feasible and well received by patients. In the pilot study, all six participants completed the mindfulness intervention and said that they would recommend it to others and that they intended to continue mindfulness on their own. Five of the six patients remained in the study through full follow-up. Among the veterans, 17 of the 35 participants have completed the study with full 3-month follow-up, with several of the others positioned for full follow-up.
Ms. DiNardo and her associates designed these studies to examine whether stress reduction with a mindfulness-based intervention was feasible and acceptable in patients with diabetes. Other research groups in Germany (Diabetes Care 2012;35:945-7) and the Netherlands (Diabetes Care 2013;36:823-30) recently reported improved outcomes in patients with diabetes who underwent mindfulness-based interventions.
The Pittsburgh researchers used mindfulness-based stress reduction training modeled on the work of Jon Kabat-Zinn, Ph.D., who first introduced this approach in the 1970s (JAMA 2008;300:1350-2). Ms. DiNardo described mindfulness as "self-regulated attention to the present moment experience with nonjudgmental acceptance of one’s thoughts, feelings, and physical sensations; attainment of a mental calmness that counteracts the stress response and develops into a permanent set of traits."
The six women with diabetes in the pilot study received weekly training modeled on the work of Dr. Kabat-Zinn during 90 minutes for 8 weeks. The classes were facilitated by a psychologist who had more than 15 years of experience with meditation. The participants were also asked to perform meditation at home during 40-minute sessions guided by a CD five to six times per week, and to maintain a diary of their home sessions.
The women had a median age of 56 years, their median HbA1c was 6.9%, their median body mass index was 38 kg/m2, and they had been diagnosed with type 2 diabetes for a median of about 5 years. All six women were college graduates, and all had annual incomes of more than $40,000.
The researchers measured outcomes using with five different indices along with HbA1c. The measured mindfulness with the Mindfulness Attention Awareness Scale and with the Five Facet Mindfulness Questionnaire, they measured stress with the Perceived Stress Scale and with the Pittsburgh Quality Sleep Index, and they measured diabetes-related distress with the Problem Areas in Diabetes Scale. In addition to seeing an average 0.7% reduction in HbA1c, the researchers also found medium to large improvements from baseline to follow-up in the Mindfulness Attention Awareness Scale, the Perceived Stress Scale, and the Problem Areas in Diabetes Scale.
Ms. DiNardo said that she had no disclosures.
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