A Randomized Controlled Trial of Acceptance and Commitment Therapy for Type 2 Diabetes Management: The Moderating Role of Coping Styles

Abstract

Background and AimEvidence of the efficacy of existing psychological interventions for self-management in diabetes is limited. The current study aimed at assessing the effects of group-based ACT on self-management of patients with T2DM, considering the moderating role of coping styles.MethodsOne hundred and six patients with type 2 diabetes were randomly assigned either to the education alone (n = 53) or to a combination of education and group-based acceptance and commitment therapy (n = 53) over a period of 10 sessions. In each group, 50 participants completed a 3 month follow-up assessment.ResultsAfter 3 months, compared to patients who received education alone, those in the group-based acceptance and commitment therapy condition were more likely to use effective coping strategies, reported better diabetes self-care, and optimum glycated hemoglobin (HbA1C) levels in the target range.ConclusionsConsideration of the role of coping style for a more accurate evaluation of the effects of acceptance and commitment therapy may be a useful addition to services provided for patients with type 2 diabetes.

Well-being interventions for individuals with diabetes: A systematic review

“…Of the other outcomes studied, significant changes were found in perceived stress [59] and guilt. Additionally, ACT-related processes, which include acceptance, mindfulness, and values, were measured in two studies, both of which found significant improvements post-intervention compared to the control group [38, 63]. …”

“…Of the four studies that measured HBA1C, only one found significant reductions post-intervention [63]. One study that did not find a significant reduction in HBA1C post-intervention did find a significant decrease in number of participants with an HBA1C below 7.0 [38].…”

“…One study that did not find a significant reduction in HBA1C post-intervention did find a significant decrease in number of participants with an HBA1C below 7.0 [38]. One of the three studies that measured diabetes self-management found a significant increase post-intervention [63]. In addition, one study found a significant increase in a composite of nutrition, exercise, and alcohol self-efficacy post-intervention [65].…”

Construction and validation of the Self-care Assessment Instrument for patients with type 2 diabetes mellitus

“…In domains E and F, the items refer to coping with the disease, addressing the acceptance and the condition of learning to live with the consequences of the treatment. The factors that hinder coping with the disease affect the performance of self-care and should, therefore, be identified by the health team 24 .…”

Acceptance-based therapy: the potential to augment behavioral interventions in the treatment of type 2 diabetes

“…Improvements in A1c from baseline to follow-up were mediated by participants' use of acceptance-based coping and engagement in diabetes self-management behaviors. In the second study, Shayeghian and colleagues randomized 106 adults with type 2 diabetes to a diabetes education only condition or a diabetes education plus ACT intervention 36 . The diabetes education plus ACT intervention consisted of ten sessions over a three-month period, while adults in the diabetes education only group participated in a 2-h workshop on diabetes control 36 .…”