August 13, 2013
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Mindfulness approach may reduce diabetes distress in women, veterans

PHILADELPHIA — Structured mindfulness-based stress reduction techniques effectively reduced diabetes distress in women and veterans, according to data presented at the American Association of Diabetes Educators Annual Meeting and Exhibition.

“Chronic stress increases the risk of stress-related conditions and diseases. It is cumulative and we know now that it contributes to a burden known as allostatic load, which results from this accumulation of dysregulated neuroendocrine response, circadian rhythms, emotions and behaviors. Fortunately, relaxation and interpretation of stress facilitates healthy coping and can ameliorate the stress response,” Monica DiNardo, CRNP, CDE, PhD, from the University of Pittsburgh, said during a presentation here. “Stress negatively affects diabetes control by direct effects on stress hormones (i.e., cortisol, adrenaline and noradrenaline) and impairs metabolic control. There are also indirect effects of stress on a patient’s ability to keep up with their self-management behaviors.”

DiNardo defined mindfulness as a self-regulated attention to the present moment experience with nonjudgmental acceptance of one’s own thoughts, feelings and physical sensations.

“It’s liken to ‘falling awake’ as opposed to ‘falling asleep’ or ‘zoning out,’ where somebody is able to relax and remain alert by decreasing a sympathetic stimulation and just being able to remain calmly alert,” she said.

DiNardo said that she and colleagues chose to study a mindfulness approach on women and US veterans with diabetes to determine the feasibility and satisfaction of such an intervention.

The women’s pilot study included an 8-week, 1.5-hour mindfulness-based stress reduction (MBSR) session with six women (median age, 56 years) with type 2 diabetes (median duration, 4.9 years) on oral medications. The sessions were led by a psychologist, and additional guided meditations were self-guided for 40 minutes, 5 to 6 days per week.

According to data, all of the women said they would recommend the technique to other women with diabetes and said they plan to continue some form of mindfulness practices.

“One woman said she felt more confident and found it easier to cope. Another said [it] made it easier to calm down and deal with the pain and aggravation of diabetes,” DiNardo said.

In the veterans’ pilot study, the researchers conducted a brief 90-minute session with 35 veterans (median age, 63 years). Patients were also encouraged to continue 10-minute sessions at home.

Based on baseline satisfaction data, 100% (n=26) agreed or strongly agreed the class was interesting and easy to understand, 96% (n=25) agreed or strongly agreed they learned something new and planned to continue practicing mindfulness and 92% (n=24) agreed or strongly agreed they would recommend a mindful stress management class to other people with diabetes. Post-data collection is still in progress, DiNardo said. – by Samantha Costa

For more information:

DiNardo MM. #W20B. Presented at: American Association of Diabetes Educators Annual Meeting and Exhibition; August 7-10; Philadelphia.

Disclosure: DiNardo reports no relevant financial disclosures.