Carolyn C Ee , Ieman Al-Kanini , Mike Armour , Milan K Piya , Rita McMorrow , Vibhuti S Rao , Dhevaksha Naidoo , Maria-Inti Metzendorf , Cynthia M Kroeger , Angelo Sabag
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引用次数: 0
Abstract
Background
Type 2 diabetes mellitus (T2DM) can lead to macro- and microvascular complications. Mindfulness-based interventions (MBIs) may improve metabolic and psychological health in individuals with T2DM. We aimed to assess the efficacy of MBIs for management of T2DM.
Methods
We searched five databases and two trial registries using a comprehensive search strategy developed by a multidisciplinary team including an information scientist. We included randomised controlled trials (RCTs) investigating MBIs for important clinical outcomes including psychological outcomes, quality of life, glycaemic control and cardiovascular risk factors in adults with T2DM. Where possible, random effects meta-analyses were conducted. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess certainty of the evidence.
Results
We included 31 RCTs (2337 participants: 1107 intervention, 1230 control). We found very low certainty evidence that MBIs may reduce stress (standardized mean difference (SMD) –1.01, confidence interval (CI) –1.91 to –0.20, 8 trials, n = 528), depression (SMD –1.26, CI –2.08 to –0.43; 7 trials, n = 570) and anxiety (SMD –0.67, CI –1.27 to –0.08; 4 studies, n = 255) at end of treatment compared to waitlist control/usual care. MBIs may have a small effect on HbA1c and systolic/diastolic blood pressure at end of treatment compared to waitlist control/usual care (HbA1c mean difference (MD) –0.44, 95 % CI –0.71 to –0.17, 9 trials, n = 734; low certainty evidence). There was very low certainty evidence that MBIs + lifestyle may have no effect on HbA1c or body weight compared to lifestyle alone.
Conclusion
MBIs may have clinical benefits (particularly psychological) for adults with T2DM, but lack of certainty in the evidence precludes clinical recommendations.
Protocol registration
Cochrane Database of Systematic Reviews, DOI: 10.1002/14651858.CD014881.
期刊介绍:
Integrative Medicine Research (IMR) is a quarterly, peer-reviewed journal focused on scientific research for integrative medicine including traditional medicine (emphasis on acupuncture and herbal medicine), complementary and alternative medicine, and systems medicine. The journal includes papers on basic research, clinical research, methodology, theory, computational analysis and modelling, topical reviews, medical history, education and policy based on physiology, pathology, diagnosis and the systems approach in the field of integrative medicine.