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Veterans’ diabetes-related distress lowered with mindfulness training
ORLANDO — Mindfulness training lowered diabetes-related distress in veterans by 41% and was associated with a lowered HbA1c as well, according to a presenter at the American Association of Diabetes Educators Annual Meeting.
“We need to find ways to incorporate innovative therapies into diabetes self-management education to promote healthy coping skills, alleviate disease burden and improve diabetes self-care,” Monica M. DiNardo, PhD, CDE, NP, health scientist at the VA Pittsburgh Healthcare System, said. “Mindfulness training is practical, evidence-based therapy and can serve as a bridge between the clinic and home. It can provide diabetes educators with a powerful tool to help facilitate healthy behavioral change.”
DiNardo presented data on 28 veterans (mean age, 62.8 years) with both type 1 and type 2 diabetes who were included in the Mindful Stress Reduction in Diabetes Education (Mind-STRIDE) study; the participants had HbA1c >7%. The mindfulness training instructed the participants in techniques to reduce stress through practical methods such as focused breathing and mindful movement.
The initial intervention consisted of a 90-minute session with group discussion, didactic presentation and formal mindfulness meditation practice. The participants were then given a diary and CD for home practice and instructed to do these for 10 to 15 minutes for 5 or 6 days a week over 3 months. They returned 1 month later for a booster session.
“Imagine talking to warriors about non-aggression. It’s ingrained in them,” she said. “We didn’t use the word ‘meditation.’ We used the word ‘mindfulness’ since there may have been a bias.”
Using validated questionnaires at baseline, 1 month and 3 months, researchers showed that diabetes-related distress decreased by 41% (P<.05). Specifically, DiNardo showed that the categories of awareness and non-judgment showed significant changes in the veterans’ responses both in coping, stress and diabetes-related distress questionnaires as well as DSM and AADE7 questionnaires. Baseline and 3-month HbA1c data moved from 8.3% to 7.3%, a significant decrease.
Though DiNardo said the study was a small, self-selected, uncontrolled sample that may not be generalized to everyone, it was a good feasibility study. Going forward, larger controlled studies would be beneficial as would the addition of real-time technology for daily practice records.
“By introducing the concepts of this study, it was not any distraction or deterrent to the educational process that occurred,” she said. “Awareness and non-judgment ... they’re very similar. Maybe they measure the same thing. Maybe when the bias and the veil of self-judgment is removed, the veterans are able to be more aware.” — by Katrina Altersitz
For more information: DiNardo MM. W13B. Presented at: The American Association of Diabetes Educators Annual Meeting 2014; August 6-9, 2014; Orlando, Fla.
Disclosure: DiNardo reported no relevant financial relationships.