Music medicine for diabetes, hypertension, and perceived stress: an open labelled randomized control trial in Sri Lanka

BACKGROUND: Chronic stress is a recognized risk factor for poor glycemic control in type 2 diabetes mellitus (T2DM). Music has shown promise as a low‐cost intervention for stress reduction, but evidence in T2DM remains limited. METHODS: We conducted an open‐label, parallel‐arm randomized controlled trial among adults with T2DM attending the National Hospital of Sri Lanka, Colombo. Participants were randomized to customized music medicine with usual care (n = 172) or usual care alone (n = 177) and followed for 3 and 6 months. Primary outcomes were HbA1c, blood pressure, pulse rate, and perceived stress measured by the Perceived Stress Scale (PSS‐10). The primary analysis used a complete‐case approach, with intention‐to‐treat sensitivity analysis using last‐observation‐carried‐forward. RESULTS: At 3 months, the treatment group showed a significantly greater reduction in HbA1c (‐0.87, 95% CI ‐1.46 to ‐0.28) and perceived stress (‐3.23, 95% CI ‐5.26 to ‐1.20) than the control group. At 6 months, although HbA1c remained numerically lower in the treatment group, the between‐group difference in the primary complete‐case analysis was not statistically significant (‐0.61, 95% CI ‐1.44 to 0.22). Age‐stratified exploratory analyses suggested greater HbA1c reduction in the <60‐year subgroup at 3 months, but these findings should be interpreted cautiously because no multiplicity adjustment was applied. No significant between‐group differences were observed for systolic blood pressure, diastolic blood pressure and pulse rate. CONCLUSION: Customized music medicine may be a useful complementary intervention for reducing perceived stress and improving short‐term glycemic control in adults with T2DM.