Effects of mindfulness-based intervention on glycemic control and psychological outcomes in people with diabetes: A systematic review and meta-analysis.

AIM: Psychological therapies showed benefits on both glycemic control and psychological outcomes in people with diabetes. However, the effects of mindfulness-based intervention (MBI) on glycemic control and psychological outcomes are inconsistent across studies and the evidence for MBI has not been summarized. We aim to identify the effects of MBI on glycemic control and psychological outcomes in people with diabetes by conducting a systematic review and meta-analysis. METHODS: Six databases (Pubmed, Embase, CINAHL, Cochrane, Web of science, and PsycINFO) were searched from inception to October 2019. Randomized controlled trials of MBI for people with type 1 and type 2 diabetes were included. Two authors independently extracted relevant data and assessed risk of bias, with a third reviewer as arbitrator. Sub-group analyses and sensitivity analyses were also performed. RESULTS: Eight studies with 841 participants met eligibility criteria. Meta-analysis demonstrated that MBI can slightly improve glycosylated hemoglobin (HbA1c) (-0.25%, 95% CI -0.43 to -0.07) and diabetes-related distress (MD -5.81; 95% CI -10.10 to -1.52), contribute to moderate effect size in reducing depression (SMD -0.56; 95% CI -0.82 to -0.30) and stress (SMD -0.53; CI -0.75 to -0.31). Subgroup analyses demonstrated greater HbA1c reductions in subgroups with baseline HbA1c level < 8% and follow-up duration > 6 months. Mixed effects were observed for anxiety. CONCLUSIONS: MBI appears to have benefits on HbA1c, depression, stress, and diabetes-related distress in people with diabetes. More rigorous studies with longer follow-up duration are warranted to establish the full potential of MBI.