Evaluation of the effects of 12 weeks mindfulness-based stress reduction on glycemic control and mental health indices in women with diabetes mellitus type 2


1 Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Diabetes mellitus is one of the major health problems in the world. Stress and mental illnesses adversely affect glycemic control. In most patients, a multidisciplinary approach including physical activity, healthy diet, and stress management is required for glycemic control. Mindfulness-based stress reduction (MBSR) is a structured group program that reduces emotional distress through self-awareness and assuming the responsibility for individual choices, and results in increased effective health behaviors. Here, we aimed to evaluate the effects of mindfulness meditation on glycemic control and mental health in patients with type 2 diabetes. Materials and Methods: This randomized clinical trial study was performed in 2018 in Isfahan city. A total number of 108 patients with diabetes mellitus type 2 were selected and allocated randomly to two groups, intervention (12 weeks MBSR program) and control (routine care). Depression, anxiety, and stress scores regarding to depression, anxiety, and stress Scale - 21 questionnaire and also amounts of fasting blood sugar (FBS) and hemoglobin A1C (HbA1C) were assessed and analyzed using independent t-test, paired t-test, Mann–Whitney U-test, and Chi-square, before and 13 weeks after educational programs. Results: The means of HbA1C, FBS, and depression, anxiety, and stress scores improved significantly after intervention in the MBSR group. Except FBS levels, all outcome variable scores' mean change was significant between the two groups. Conclusions: In general, this study revealed that mindfulness meditation could be helpful in improving the quality of mental health and lowering glycemic control indices in patients with type 2 diabetes mellitus.


Animaw W, Seyoum Y. Increasing prevalence of diabetes mellitus in a developing country and its related factors. PLoS One 2017;12:e0187670.  Back to cited text no. 1
Whitebird RR, Kreitzer MJ, Vazquez-Benitez G, Enstad CJ. Reducing diabetes distress and improving self-management with mindfulness. Soc Work Health Care 2018;57:48-65.  Back to cited text no. 2
Thind H, Fava JL, Guthrie KM, Stroud L, Gopalakrishnan G, Sillice M, et al. Yoga as a complementary therapy for adults with type 2 diabetes: Design and rationale of the healthy, active, and in control (HA1C) study. Int J Yoga Therap 2018;28:123-32.  Back to cited text no. 3
Medina WL, Wilson D, de Salvo V, Vannucchi B, de Souza ÉL, Lucena L, et al. Effects of mindfulness on diabetes mellitus: Rationale and overview. Curr Diabetes Rev 2017;13:141-7.  Back to cited text no. 4
Varvogli L, Darviri C. Stress management techniques: Evidence-based procedures that reduce stress and promote health. Health Sci J 2011;5:74.  Back to cited text no. 5
Jung HY, Lee H, Park J. Comparison of the effects of Korean mindfulness-based stress reduction, walking, and patient education in diabetes mellitus. Nurs Health Sci 2015;17:516-25.  Back to cited text no. 6
Youngwanichsetha S, Phumdoung S, Ingkathawornwong T. The effects of mindfulness eating and yoga exercise on blood sugar levels of pregnant women with gestational diabetes mellitus. Appl Nurs Res 2014;27:227-30.  Back to cited text no. 7
Rosenzweig S, Reibel DK, Greeson JM, Edman JS, Jasser SA, McMearty KD, et al. Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: A pilot study. Altern Ther Health Med 2007;13:36-8.  Back to cited text no. 8
Carpenter R, DiChiacchio T, Barker K. Interventions for self-management of type 2 diabetes: An integrative review. Int J Nurs Sci 2019;6:70-91.  Back to cited text no. 9
Hartmann M, Kopf S, Kircher C, Faude-Lang V, Djuric Z, Augstein F, et al. Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients: Design and first results of a randomized controlled trial (the Heidelberger diabetes and stress-study). Diabetes Care 2012;35:945-7.  Back to cited text no. 10
Merkes M. Mindfulness-based stress reduction for people with chronic diseases. Aust J Prim Health 2010;16:200-10.  Back to cited text no. 11
Fanning J, Osborn CY, Lagotte AE, Mayberry LS. Relationships between dispositional mindfulness, health behaviors, and hemoglobin A1c among adults with type 2 diabetes. J Behav Med 2018;41:798-805.  Back to cited text no. 12
Koloverou E, Tentolouris N, Bakoula C, Darviri C, Chrousos G. Implementation of a stress management program in outpatients with type 2 diabetes mellitus: A randomized controlled trial. Hormones (Athens) 2014;13:509-18.  Back to cited text no. 13
Keyworth C, Knopp J, Roughley K, Dickens C, Bold S, Coventry P. A mixed-methods pilot study of the acceptability and effectiveness of a brief meditation and mindfulness intervention for people with diabetes and coronary heart disease. Behav Med 2014;40:53-64.  Back to cited text no. 14
Henry JD, Crawford JR. The short-form version of the depression anxiety stress scales (DASS-21): Construct validity and normative data in a large non-clinical sample. Br J Clin Psychol 2005;44:227-39.  Back to cited text no. 15
Sahebi A, Asghari MJ, Salari R. Validation of depression anxiety and stress scale (DASS-21) for Iranian population. Iranian Psychology, 2005; 1 (4): 50–60.  Back to cited text no. 16
Bay R, Bay F. Combined therapy using acupressure therapy, hypnotherapy, and transcendental meditation versus placebo in type 2 diabetes. J Acupunct Meridian Stud 2011;4:183-6.  Back to cited text no. 17
Khatri D, Mathur KC, Gahlot S, Jain S, Agrawal RP. Effects of yoga and meditation on clinical and biochemical parameters of metabolic syndrome. Diabetes Res Clin Pract 2007;78:e9-10.  Back to cited text no. 18
Priya G, Kalra S. Mind-body interactions and mindfulness meditation in diabetes. Eur Endocrinol 2018;14:35-41.  Back to cited text no. 19
Kumar V, Jagannathan A, Philip M, Thulasi A, Angadi P, Raghuram N. Role of yoga for patients with type II diabetes mellitus: A systematic review and meta-analysis. Complement Ther Med 2016;25:104-12.  Back to cited text no. 20
Armani Kian A, Vahdani B, Noorbala AA, Nejatisafa A, Arbabi M, Zenoozian S, et al. The impact of Mindfulness-based stress reduction on emotional wellbeing and glycemic Control of patients with type 2 diabetes mellitus. J Diabetes Res. eCollection 2018; Article ID 1986820, 6 pages. https://doi.org/10.1155/2018/1986820  Back to cited text no. 21
Boehm JK, Trudel-Fitzgerald C, Kivimaki M, Kubzansky LD. The prospective association between positive psychological well-being and diabetes. Health Psychol 2015;34:1013-21.  Back to cited text no. 22
Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, et al. Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Intern Med 2014;174:357-68.  Back to cited text no. 23
Cash M, Whittingham K. What facets of mindfulness contribute to psychological well-being and depressive, anxious, and stress-related symptomatology? Mindfulness 2010;1:177-82.  Back to cited text no. 24
Sudhir PM. Advances in psychological interventions for lifestyle disorders: Overview of interventions in cardiovascular disorder and type 2 diabetes mellitus. Curr Opin Psychiatry 2017;30:346-51.  Back to cited text no. 25
van Son J, Nyklícek I, Pop VJ, Blonk MC, Erdtsieck RJ, Spooren PF, et al. The effects of a mindfulness-based intervention on emotional distress, quality of life, and HbA (1c) in outpatients with diabetes (DiaMind): A randomized controlled trial. Diabetes Care 2013;36:823-30.  Back to cited text no. 26
Noordali F, Cumming J, Thompson JL. Effectiveness of mindfulness-based interventions on physiological and psychological complications in adults with diabetes: A systematic review. J Health Psychol 2017;22:965-83.  Back to cited text no. 27