Mindfulness Practice for Glycemic Control: Could it be a New Strategy for an Old Problem? A Systematic Review and Meta-Analysis

Abstract

Background: The management of type 2 diabetes mellitus (T2DM) requires a complex and organized care that includes patient lifestyle change. Additionally, emotional well-being is an important part of self-management, and it may impair the individual’s adherence. Therefore, equipping them with the necessary coping and self-care techniques may be an important step in managing diabetes. Objective: to evaluate the effect of interventions using established based-mindfulness protocols on glycemic control of individuals T2DM. Methods: Data sources: Two electronic databases (PubMed and EMBASE) were searched from inception to December 2019. We limited our search to published studies in the English, Spanish and Portuguese language. Study selection: Randomized clinical trials that assessed the effects of mindfulness in individuals with T2DM were selected. Data extraction: Two authors independently assessed risk of bias and extracted data from the included trials. Data were pooled using inverse-variance random-effects meta-analyses. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: Four randomized trials were included. There were no differences in blood glucose change (mean difference between groups (MD) -0.73mg/dl; 95% CI, -10.49; 9.02; I2 =0%; very low quality of evidence) or glycated hemoglobin (MD 0.05%; 95%CI -0.22 to 0.32; I2 =29%; very low quality of evidence). Conclusions: Although the quality of current evidence is very low, our findings suggest that established protocols involving mindfulness has no effect on blood glucose or glycated hemoglobin in individuals with T2DM. Indeed, largescale trials are needed to evaluate the contribution of mindfulness on glycemic control in the clinical practice.