Psychological interventions for diabetes-related distress in adults with type 2 diabetes mellitus
Open accessAbstract
BACKGROUND: Many adults with type 2 diabetes mellitus (T2DM) experience a psychosocial burden and mental health problems associated with the disease. Diabetes-related distress (DRD) has distinct effects on self-care behaviours and disease control. Improving DRD in adults with T2DM could enhance psychological well-being, health-related quality of life, self-care abilities and disease control, also reducing depressive symptoms. OBJECTIVES: To assess the effects of psychological interventions for diabetes-related distress in adults with T2DM. SEARCH METHODS: We searched the Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, BASE, WHO ICTRP Search Portal and ClinicalTrials.gov. The date of the last search was December 2014 for BASE and 21 September 2016 for all other databases. SELECTION CRITERIA: We included randomised controlled trials (RCTs) on the effects of psychological interventions for DRD in adults (18 years and older) with T2DM. We included trials if they compared different psychological interventions or compared a psychological intervention with usual care. Primary outcomes were DRD, health-related quality of life (HRQoL) and adverse events. Secondary outcomes were self-efficacy, glycosylated haemoglobin A1c (HbA1c), blood pressure, diabetes-related complications, all-cause mortality and socioeconomic effects. DATA COLLECTION AND ANALYSIS: Two review authors independently identified publications for inclusion and extracted data. We classified interventions according to their focus on emotion, cognition or emotion-cognition. We performed random-effects meta-analyses to compute overall estimates. MAIN RESULTS: We identified 30 RCTs with 9177 participants. Sixteen trials were parallel two-arm RCTs, and seven were three-arm parallel trials. There were also seven cluster-randomised trials: two had four arms, and the remaining five had two arms. The median duration of the intervention was six months (range 1 week to 24 months), and the median follow-up period was 12 months (range 0 to 12 months). The trials included a wide spectrum of interventions and were both individual- and group-based.A meta-analysis of all psychological interventions combined versus usual care showed no firm effect on DRD (standardised mean difference (SMD) -0.07; 95% CI -0.16 to 0.03; P = 0.17; 3315 participants; 12 trials; low-quality evidence), HRQoL (SMD 0.01; 95% CI -0.09 to 0.11; P = 0.87; 1932 participants; 5 trials; low-quality evidence), all-cause mortality (11 per 1000 versus 11 per 1000; risk ratio (RR) 1.01; 95% CI 0.17 to 6.03; P = 0.99; 1376 participants; 3 trials; low-quality evidence) or adverse events (17 per 1000 versus 41 per 1000; RR 2.40; 95% CI 0.78 to 7.39; P = 0.13; 438 participants; 3 trials; low-quality evidence). We saw small beneficial effects on self-efficacy and HbA1c at medium-term follow-up (6 to 12 months): on self-efficacy the SMD was 0.15 (95% CI 0.00 to 0.30; P = 0.05; 2675 participants; 6 trials; low-quality evidence) in favour of psychological interventions; on HbA1c there was a mean difference (MD) of -0.14% (95% CI -0.27 to 0.00; P = 0.05; 3165 participants; 11 trials; low-quality evidence) in favour of psychological interventions. Our included trials did not report diabetes-related complications or socioeconomic effects.Many trials were small and were at high risk of bias for incomplete outcome data as well as possible performance and detection biases in the subjective questionnaire-based outcomes assessment, and some appeared to be at risk of selective reporting. There are four trials awaiting further classification. These are parallel RCTs with cognition-focused and emotion-cognition focused interventions. There are another 18 ongoing trials, likely focusing on emotion-cognition or cognition, assessing interventions such as diabetes self-management support, telephone-based cognitive behavioural therapy, stress management and a web application for problem solving in diabetes management. Most of these trials have a community setting and are based in the USA. AUTHORS' CONCLUSIONS: Low-quality evidence showed that none of the psychological interventions would improve DRD more than usual care. Low-quality evidence is available for improved self-efficacy and HbA1c after psychological interventions. This means that we are uncertain about the effects of psychological interventions on these outcomes. However, psychological interventions probably have no substantial adverse events compared to usual care. More high-quality research with emotion-focused programmes, in non-US and non-European settings and in low- and middle-income countries, is needed.
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CBT and other approaches designed to directly reduce distress or diabetes distress have failed to consistently improve clinical outcomes for people with diabetes.
“Thus, CBT and other approaches designed to directly reduce distress or DD have failed to consistently improve clinical outcomes for people with diabetes (6–8,11).”
From Addressing emotional distress to improve outcomes in adults with type 1 diabetes: Protocol for ACT1VATE randomized controlled trial (2024) · cites this paper as [8]
The Background reports no firm effect on blood pressure and describes the evidence as low quality, which supports the claim that clinical benefits were not consistent. But the Discussion reports improved HbA1c compared with usual care, and the review covers adults with type 2 diabetes, not all people with diabetes. The claim omits both qualifications. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPrevious trials and reviews suggested that psychological interventions were effective in improving diabetes-related knowledge, modifying illness perceptions, and enhancing self-efficacy.
“Previous trials and reviews suggested that these psychological interventions were effective in improving patients' diabetes-related knowledge, modifying illness perceptions, and enhancing self-efficacy (Chew et al., 2017).”
From Effectiveness of acceptance and commitment therapy in people with type 2 diabetes mellitus: A systematic review and meta‐analysis. (2024) · cites this paper as Chew et al., 2017
The Discussion (page unavailable) reports improved self-efficacy compared with usual care, although the authors’ conclusions describe the benefit as small and uncertain. The Background discusses changing illness perceptions as a proposed mechanism, not an established intervention effect; the passages found do not report improved diabetes-related knowledge. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCultural factors such as machismo, familismo, and simpatia have high potential to adversely impact individuals' engagement in their diabetes care and management.
“These are examples of cultural factors with high potential to adversely impact individuals’ engagement in their diabetes care and management.”
From Addressing emotional distress to improve outcomes in adults with type 1 diabetes: Protocol for ACT1VATE randomized controlled trial (2024) · cites this paper as [8]
The Background discusses diabetes distress, fatalism, social support, and reduced self-care, but does not identify machismo, familismo, or simpatia as factors affecting diabetes care. Searches for those terms and for cultural barriers to self-management found no passage in our copy making the attributed point; the copy is truncated. (LLM, conf=0.74)
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Japanese clinical practice guideline for diabetes 2019
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Japanese Clinical Practice Guideline for Diabetes 2019
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Mika Kivimaki, B., Bartolomucci, A., & Kawachi, I. I. (2022) · Nature Reviews Endocrinology · doi:10.1038/s41574-022-00746-8 · Cited by 329 · see citing works
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Hartmann‐Boyce, J., Morris, E. M., Goyder, C., Kinton, J., Perring, J. C., Nunan, D., Mahtani, K. R., Buse, J. B., Prato, S. D., Ji, L., et al. (2020) · Diabetes Care · doi:10.2337/dc20-1192 · Cited by 256 · see citing works
“In the general literature, there is mixed evidence on interventions to reduce diabetes-related distress, and the vast majority of interventions tested involve face-to-face contactdan unsuitable format in the current context (39).”
Schmidt, C. B., van Loon, B. J. P., Vergouwen, A. C. M., Snoek, F. J., & Honig, A. (2018) · Diabetic Medicine · doi:10.1111/dme.13709 · Cited by 170 · see citing works
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Mathiesen, A. S., Egerod, I., Jensen, T. J., Kaldan, G., Langberg, H., & Thomsen, T. (2018) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s179301 · Cited by 80 · see citing works
“Psychosocial interventions that were emotion focused and/ or cognition focused and administered person-to-person, in groups, or digitally, by peers, caregivers or health care profes- sionals, either alone or in combination, for reducing DD in vulnerable people with T2DM.”
InfluentialNgan, H. Y., Chong, Y. Y., & Chien, W. T. (2021) · Diabetic Medicine · doi:10.1111/dme.14525 · Cited by 77 · see citing works
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The Health-Related Quality of Life of Patients with Type 2 Diabetes in Saudi Arabia
AbuAlhommos, A. K., Alturaifi, A. H., Hamdhah, A. M. A.-B., Al-Ramadhan, H. H., Ali, Z. A. A., & Al Nasser, H. J. (2022) · Patient Preference and Adherence · doi:10.2147/ppa.s353525 · Cited by 45 · see citing works
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Research Progress on Non-Drug Treatment for Blood Glucose Control of Type 2 Diabetes Mellitus
Wei, J., Wang, Q., Zheng, H., & Wei, F. (2018) · Chinese Journal of Integrative Medicine · doi:10.1007/s11655-018-2844-2 · Cited by 39 · see citing works
Chew, B., Vos, R. C., Stellato, R. K., Ismail, M., & Rutten, G. E. H. M. (2018) · Diabetic Medicine · doi:10.1111/dme.13615 · Cited by 37 · see citing works
Self-citationMcGloin, H., Devane, D., McIntosh, C. D., Winkley, K., & Gethin, G. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012835.pub2 · Cited by 36 · see citing works
McMorrow, R., Hunter, B., Hendrieckx, C., Kwaśnicka, D., Speight, J., Cussen, L., Ho, F. C. S., Emery, J. D., & Manski-Nankervis, J.-A. E. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-054650 · Cited by 39 · see citing works
Maina, P. M., Pienaar, M., & Reid, M. (2023) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2023.100136 · Cited by 47 · see citing works
“…that implemented psychological interventions for patients with diabetes found that members of the intervention groups had slightly better levels of glycosylated haemoglobin than the controls (Chew et al., 2017; Winkley et al., 2020), as well as somewhat higher self-efficacy (Chew et al., 2017).”
BackgroundPsychological Aspects of Diabetes
Bhat, N. A., Muliyala, K. P., & Chaturvedi, S. K. (2020) · EMJ Diabetes · doi:10.33590/emjdiabet/20-00174 · Cited by 34 · see citing works
Zu, W., Zhang, S., Du, L., Huang, X., Nie, W., & Wang, L. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06125-z · Cited by 37 · see citing works
“Finally, we did not find short-and long-term effects of psychological intervention on HbA1c, which is inconsistent with the findings of Chew et al. who showed a small benefit on HbA1c at 6–12 months of follow-up [12].”
BackgroundResultGriauzde, D. H., Ling, G., Wray, D., DeJonckheere, M. J., Mizokami‐Stout, K., Saslow, L. R., Fenske, J., Serlin, D. C., Stonebraker, S., Nisha, T., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/31184 · Cited by 30 · see citing works
“Although CGM technology can empower and motivate patients with type 1 diabetes mellitus who are accustomed to routine self-monitoring of blood glucose to guide insulin dosing [36], CGM technology may enhance diabetes-related distress, which is a known barrier to T2DM self-management [38].”
BackgroundMizokami‐Stout, K., Choi, H., Richardson, C. R., Piatt, G., & Heisler, M. (2021) · JMIR Diabetes · doi:10.2196/21400 · Cited by 28 · see citing works
“Prior RCTs and systematic reviews have elucidated that psychosocial and psychological interventions, particularly those that are tailored specifically for diabetes and have a patient empowerment or motivational interviewing component, are more successful at improving glycemic outcomes in addition to reducing diabetes…”
BackgroundSendekie, A. K., Limenh, L. W., Bizuneh, G. K., Kasahun, A. E., Wondm, S. A., Tamene, F. B., Dagnew, E. M., Gete, K. Y., Kassaw, A. T., Dagnaw, A. D., et al. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1488023 · Cited by 30 · see citing works
“Programs integrating psychological support, medication management, and comorbidity education can significantly enhance patient well-being and reduce distress (61, 62).”
Arend, F. M., Müller, U., SCHMITT, A. J., Voigt, M., & Kuniß, N. (2019) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/a-0977-2667 · Cited by 26 · see citing works
Tunsuchart, K., Lerttrakarnnon, P., Srithanaviboonchai, K., Likhitsathian, S., & Skulphan, S. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17155564 · Cited by 25 · see citing works
“Many adults with T2DM experience a psychosocial burden and mental health problems associated with the disease [3].”
BackgroundDiriba, D. C., Leung, D. Y. P., & Suen, L. K. P. (2020) · Diabetic Medicine · doi:10.1111/dme.14501 · Cited by 27 · see citing works
Chen, P., Callisaya, M. L., Wills, K. E., Greenaway, T. M., & Winzenberg, T. M. (2022) · PLoS ONE · doi:10.1371/journal.pone.0267265 · Cited by 23 · see citing works
Namdeo, M. K., Verma, S., Gupta, R. D., Islam, R., Nazneen, S., & Rawal, L. B. (2023) · Global Health Research and Policy · doi:10.1186/s41256-023-00328-9 · Cited by 23 · see citing works
“Research findings indicate that the incorporation of mental health services into chronic disease care has shown positive outcomes, leading to improvements in both physical health conditions and depression [30, 31].”
BackgroundMathiesen, A. S., Rothmann, M. J., Zoffmann, V., Jakobsen, J. C., Gluud, C. N., Lindschou, J., Due‐Christensen, M., Rasmussen, B., Marqvorsen, E. H. S., & Thomsen, T. (2021) · Systematic Reviews · doi:10.1186/s13643-020-01566-5 · Cited by 22 · see citing works
“Existing diabetes self-management interventions and interventions focusing on behaviour change vary widely in their content, and their sustained long-term effectiveness is uncertain [22, 23].”
BackgroundLevy, N., Park, A., Solis, D., Hu, L., Langford, A. T., Wang, B., & Rogers, E. (2022) · JMIR Formative Research · doi:10.2196/40164 · Cited by 20 · see citing works
“6%) out of any cohort for which DRD prevalence has been reported [17-22,32-37].”
BackgroundHamal, C., Velugoti, L. S. D. R., Tabowei, G., Gaddipati, G. N., Mukhtar, M., Alzubaidee, M. J., Dwarampudi, R. S., Mathew, S., Bichenapally, S., Khachatryan, V., et al. (2022) · Cureus · doi:10.7759/cureus.28609 · Cited by 20 · see citing works
Li, D., Dai, F.-M., Xu, J., & Jiang, M. (2020) · BioMed Research International · doi:10.1155/2020/8691451 · Cited by 19 · see citing works
Diabetes-related distress and daily cortisol output in people with Type 2 diabetes
Bawa, H., Poole, L., Cooke, D. D., Panagi, L., Steptoe, A., & Hackett, R. A. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108472 · Cited by 19 · see citing works
“Directly, targeting distress itself through psychological interventions could also be advantageous, as review evidence from 30 randomized controlled trials suggests that diabetes-related distress is amenable to intervention, with benefits for HbA1c at 6-12 month follow-up [43].”
BackgroundOyedeji, A. D., Ullah, I., Weich, S., Bentall, R. P., & Booth, A. (2022) · International Journal of Mental Health Systems · doi:10.1186/s13033-022-00521-2 · Cited by 21 · see citing works
“Systematic reviews to evaluate the effects of psychological interventions on glycaemic control and mental health included but did not distinguish between studies which have looked at both specialists and non-specialists delivering the intervention [18, 21, 22].”
BackgroundMoawd, S. A. A. (2022) · Journal of Diabetes Research · doi:10.1155/2022/1633448 · Cited by 18 · see citing works
Scotti, K. L., Young, S. M. N., Gainey, M. A., & Lan, H. (2025) · Cochrane Evidence Synthesis and Methods · doi:10.1002/cesm.70046 · Cited by 25 · see citing works
Jung, A., Du, Y., Nübel, J., Busch, M. A., Heidemann, C., Scheidt‐Nave, C., & Baumert, J. (2021) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2020-001804 · Cited by 17 · see citing works
“In order to adjust care processes to the needs of patients with diabetes, future research needs to unravel the complex inter-relationship between depression, diabetes-related distress and diabetes outcomes.”
Management of Psychiatric Disorders in Patients with Endocrine Disorders
Mishra, K. K., Sawant, N., & Garg, S. (2022) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry.indianjpsychiatry_30_22 · Cited by 18 · see citing works
“• Mild depressive cases do well with cognitive behavioral therapy (CBT) [30,31] • CBT can improve diabetes-related distress • CBT improved depression than diabetes-related distress in some studies as interventions were not tailored in problem areas of self-care [30,31] • Short-term reduction in…”
BackgroundMeditation for the primary and secondary prevention of cardiovascular disease
Rees, K., Takeda, A., Court, R. A., Kudrna, L., Hartley, L., & Ernst, E. (2024) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013358.pub2 · Cited by 18 · see citing works
Kong, L., Hu, P. F., Zhao, Q., Yao, H., & Chen, S. (2020) · International Journal of Nursing Practice · doi:10.1111/ijn.12830 · Cited by 17 · see citing works
Stress-Reducing Psychological Interventions as Adjuvant Therapies for Diabetic Chronic Wounds
Carvalho, E., Pombeiro, I., Moura, J., & Pereira, M. G. (2021) · Current Diabetes Reviews · doi:10.2174/1573399817666210806112813 · Cited by 18 · see citing works
Mathiesen, A. S., Zoffmann, V., Lindschou, J., Jakobsen, J. C., Gluud, C. N., Due‐Christensen, M., Rasmussen, B., Marqvorsen, E. H. S., Lund-Jacobsen, T., Skytte, T. B., et al. (2023) · Systematic Reviews · doi:10.1186/s13643-023-02308-z · Cited by 15 · see citing works
“Meta-analyses of psychological interventions addressing emotions, cognitions, and behaviors proved noneffective for reducing glycated hemoglobin (HbA1c) in people with type 1 [8] or type 2 diabetes [4].”
BackgroundBeaudin, J., Chouinard, M., Hudon, É., & Hudon, C. (2024) · BMC Family Practice · doi:10.1186/s12875-024-02464-8 · Cited by 15 · see citing works
The Lived Experience of Older Adults With Type 2 Diabetes Mellitus and Diabetes-Related Distress
Hernandez, L., Leutwyler, H. C., Cataldo, J. K., Kanaya, A. M., Swislocki, A., & Chesla, C. A. (2020) · Journal of Gerontological Nursing · doi:10.3928/00989134-20200129-05 · Cited by 15 · see citing works
Efthymiadis, A., Bourlaki, M., & Bastounis, A. (2022) · Diabetology International · doi:10.1007/s13340-021-00564-9 · Cited by 13 · see citing works
“Furthermore, a meta-analysis that included 30 randomised controlled trials has failed to provide evidence that psychological interventions could improve diabetes-related distress more than usual care in people with type 2 diabetes [15].”
BackgroundDu, Q.-H., Zhang, Z.-C., Yang, Y., Luo, X.-X., Liu, L., & Jia, H. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1414903 · Cited by 14 · see citing works
HeLP-Diabetes: randomised controlled trial protocol
Murray, E., Dack, C., Barnard, M., Farmer, A. A., Li, J., Michie, S., Pal, K., Parrott, S., Ross, J., Sweeting, M. J., et al. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-1246-9 · Cited by 14 · see citing works
Chew, B.-H., Fernandez, A., & Sazlina, S.-G. (2018) · Psychology Research and Behavior Management · doi:10.2147/prbm.s117224 · Cited by 14 · see citing works
“71 In the following paragraphs, we assimilate the commonly held concepts, theories 53 and perspectives of health psychology 72 in patient-centered empowerment/intervention strategies 73,74 and put forth a hypothesis that reliable interventions in supporting patient’s self-management may have to…”
Self-citationWang, M., Liu, Q., Zhu, Z., Guo, X., Hu, X., & Cheng, L. (2024) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12719 · Cited by 12 · see citing works
Hassan, F., & Hatah, E. (2022) · International Journal of Social and Psychological Aspects of Healthcare · doi:10.51847/jmkuhoebqx · Cited by 12 · see citing works
Liang, Z., Jia, Y., Zhao, L., Zhu, R., He, X., Tong, B., Yang, F., Hao, L., Cui, P., & Yuan, J. (2021) · Aging · doi:10.18632/aging.203586 · Cited by 12 · see citing works
“The depressed DM patients often show some negative coping strategies that can affect the outcomes of treatment, resulting in the decreased treatment adherence, increased diabetes fatalism and low-quality of life [14].”
BackgroundValidity and Reliability of the Korean Version of the Self-Care of Diabetes Inventory (SCODI-K)
Kong, S.-Y., & Cho, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182212179 · Cited by 12 · see citing works
“Third, psychological factors affecting the self-care of diabetic patients in previous studies are included in the self-confidence domain of SCODI [9,11,12,14,15,21].”
BackgroundNgan, H. Y., Chong, Y. Y., Loo, K. M., & Chien, W. T. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.09.002 · Cited by 14 · see citing works
Jiang, T., Liu, C., Jiang, P., Cheng, W., Sun, X., Yuan, J., Wang, Q., Wang, Y., Hong, S., Shen, H., et al. (2023) · International Journal of Clinical Practice · doi:10.1155/2023/2493634 · Cited by 11 · see citing works
“Increased self-efcacy also contributes to lower HbA1c and enhancing well-being [4, 45, 46].”
BackgroundColes, B., Zaccardi, F., Seidu, S., Gillies, C. L., Davies, M. J., Hvid, C. A., & Khunti, K. K. (2021) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14340 · Cited by 11 · see citing works
Marples, O., Resca, L., Plavska, J., Hassan, S., Mistry, V., Mallik, R., & Brown, A. C. (2022) · Nutrients · doi:10.3390/nu14153146 · Cited by 10 · see citing works
“People living with T2DM have an increased risk of having poorer mental health including diabetes distress, depression, and anxiety [28].”
Akshatha, S., & Nayak, U. B. (2024) · Medicine in Drug Discovery · doi:10.1016/j.medidd.2024.100196 · Cited by 15 · see citing works
People with diabetes do not learn and recall their diabetes foot education: a cohort study
Yuncken, J., Williams, C., Stolwyk, R. J., & Haines, T. P. (2018) · Endocrine · doi:10.1007/s12020-018-1714-1 · Cited by 10 · see citing works
Chew, B., Vos, R. C., Fernandez, A., Ghazali, S. S., Shamsuddin, N. H., Ismail, M., & Rutten, G. E. H. M. (2019) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018819853761 · Cited by 9 · see citing works
Self-citationHu, H., Kuang, L., Dai, H., & Sheng, Y. (2024) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20241029-01 · Cited by 8 · see citing works
Losonczi, A., Kazinczi, C., Fehervari, F., Illenyi, M., Herold, Z., Palmai, D., Rigó, A., Varga, É. K., Zemplenyi, Z. M., Vincze, Á., et al. (2025) · Diabetology · doi:10.3390/diabetology6030019 · Cited by 11 · see citing works
Comparative Analysis of Different Classifiers Using Machine Learning Algorithm for Diabetes Mellitus
Sharma, S. K., Priyadarshi, A., Mohapatra, S. K., Pradhan, J., & Sarangi, P. K. (2022) · Artificial intelligence-enhanced software and systems engineering · doi:10.1007/978-3-031-11713-8_4 · Cited by 8 · see citing works
Rohde, C., Schmitz, N., Thomsen, R. W., & Østergaard, S. D. (2021) · Acta Neuropsychiatrica · doi:10.1017/neu.2020.39 · Cited by 7 · see citing works
Zhang, Y. H., Zhang, D., Long, T., Wu, Y., Huang, J., Zhang, Y., & Li, M. (2024) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2024.111863 · Cited by 7 · see citing works
Silke, L., Kirresh, O., Sturt, J. A., & Lempp, H. K. (2021) · BMC Rheumatology · doi:10.1186/s41927-021-00220-4 · Cited by 7 · see citing works
“In general, reviews found psycho-educational treatments resulted in a low to moderate effect on DSD reduction and more intensive and longer duration interventions seem to achieve a greater effect [13, 14, 45, 46].”
ResultCherry, M. G., Brown, S. L., Purewal, R., & Fisher, P. (2023) · British Journal of Health Psychology · doi:10.1111/bjhp.12655 · Cited by 7 · see citing works
Zara, S., Kruse, J., Leveling, A. M., Schmitz, J., Hempler, I., & Kampling, H. (2022) · JMIR Research Protocols · doi:10.2196/38477 · Cited by 7 · see citing works
McMorrow, R., Hunter, B., Hendrieckx, C., Kwaśnicka, D., Cussen, L., Ho, F. C. S., Speight, J., Emery, J. D., & Manski-Nankervis, J.-A. E. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-044888 · Cited by 6 · see citing works
Lu, Y., Gao, M., Zhang, L., Shi, M., Zhou, H., Zhou, H., Che, H., Fei, X., Chen, J., & Li, Y. (2023) · Nursing Open · doi:10.1002/nop2.1883 · Cited by 6 · see citing works
“More importantly, patients suffering from T2DM had a higher mental health risk (Chew et al., 2017).”
Zhang, J., Wang, C., Huang, L., & Zhang, J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1067238 · Cited by 6 · see citing works
Jafari, A., Moshki, M., Naddafi, F., Taghinezhad, F., Khorasani, E. C., Karimian, N., Farhadian, Z., & Alizadeh, H. (2024) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-024-01375-z · Cited by 6 · see citing works
“The results of a systematic review and meta-analysis about psychological interventions for distress diabetes showed that different psychological interventions did not have a decisive effect on diabetes distress in the population with T2D compared to conventional care [57].”
BackgroundWong, S., Lew, J., Soon, W., Griva, K., Smith, H. E., & Lim, S.-C. (2024) · Patient Education and Counseling · doi:10.1016/j.pec.2024.108482 · Cited by 5 · see citing works
Anderson, D. J., Sturt, J. A., McDonald, N., Sapkota, D., Porter‐Steele, J., Rogers, R. L., Temple, A., Seib, C. A., McGuire, A., Tjondronegoro, D., et al. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108654 · Cited by 5 · see citing works
Pfoh, E. R., Linfield, D. T., Speaker, S. L., Roufael, J., Yan, C., Misra‐Hebert, A. D., & Rothberg, M. B. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-07047-2 · Cited by 5 · see citing works
McGloin, H., Devane, D., McIntosh, C. D., Winkley, K., & Gethin, G. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012835 · Cited by 5 · see citing works
Factors associated with work ability in adults with diabetes
McCarthy, M. M., Yan, J., & Dickson, V. V. (2021) · Applied Nursing Research · doi:10.1016/j.apnr.2021.151478 · Cited by 5 · see citing works
Pedrosa, A., Furtado, G. E., Barros, M. P., Bachi, A. L. L., Ferreira, J. P., Sardão, V. A., Rama, L. M. P. L., & Teixeira, A. M. (2022) · Diabetology · doi:10.3390/diabetology4010002 · Cited by 5 · see citing works
“Insulin deficiency also invariably leads to chronic hyperglycaemia, causing disturbances in carbohydrate, fat, and protein metabolism [6].”
BackgroundTreatment of type 2 diabetes and stress using neuro-emotional technique: case report
Bablis, P., Day, R. R., & Pollard, H. P. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1382757 · Cited by 5 · see citing works
Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study
Zhou, F., Deng, L., Guo, C., Long, K., Xie, L., Yang, T., & Lv, Q. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-079674 · Cited by 4 · see citing works
“Provenance and peer review Not commissioned; externally peer reviewed.”
BackgroundÖztürk, Z., Turan, G. B., & Dönmez, O. (2024) · Nursing Open · doi:10.1002/nop2.70044 · Cited by 4 · see citing works
“(Chew et al., 2017).”
BackgroundPhilis‐Tsimikas, A., Fortmann, A. L., Clark, T. L., Bagsic, S. R. S., Farcas, E., Roesch, S. C., SCHULTZ, J. H., Gilmer, T., Godino, J., Savin, K. L., et al. (2024) · Annals of Behavioral Medicine · doi:10.1093/abm/kaae077 · Cited by 5 · see citing works
Zamani, S., Abdoli, S., Ghadirian, F., & Dehkordi, L. M. (2025) · BMC Psychology · doi:10.1186/s40359-025-03258-y · Cited by 4 · see citing works
“A Cochrane systematic review found no significant effect of psychological interventions on diabetes distress compared to usual care in T1D populations [16], highlighting the ongoing need for innovative, scalable, and effective approaches.”
Coaching and Education for Diabetes Distress (CEDD): Protocol for a Randomized Controlled Trial
Chima, C. C., Salemi, J. L., Sidani, M. A., & Zoorob, R. (2019) · JMIR Research Protocols · doi:10.2196/12166 · Cited by 4 · see citing works
“Even though some interventions have incorporated elements of coaching [7,8], only 1 study has explicitly sought to address DD as a primary outcome using HC [14].”
Meditation for the primary and secondary prevention of cardiovascular disease
Rees, K., Court, R. A., Takeda, A., & Ernst, E. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013358 · Cited by 4 · see citing works
Liu, G., Li, T., Chen, C., & Xiao, N. (2025) · Journal of Diabetes Research · doi:10.1155/jdr/5164503 · Cited by 4 · see citing works
“Similarly, Guy E. H. M. Rutten from the University Medical Centre Utrecht has focused on depression symptoms, well-being, and HRQoL [32] and examined the e ffi cacy of self-management education and psychological support in alleviating patient distress [33 – 35].”
Schipper, S. B. J., Karagiannis, T., Zaccardi, F., Remmelzwaal, S., Blom, M. T., Dagan, N., Schoonmade, L. J., Langendam, M. W., Mb, J., Jensen, W., et al. (2026) · Diabetologia · doi:10.1007/s00125-026-06789-0 · Cited by 3 · see citing works
“For instance, a large Cochrane review specifically focused on psychological interventions for diabetes distress in adults with type 2 diabetes found a small but significant effect on diabetes distress in favour of psychological interventions compared with usual care [11].”
Factors Associated with Diabetes-Related Distress in Patients with Type 2 Diabetes Mellitus
Duka, K., Onea, C. R., & Cernea, S. (2021) · Journal of Interdisciplinary Medicine · doi:10.2478/jim-2021-0027 · Cited by 3 · see citing works
Rondhianto, R., Ridla, A. Z., & Budi, F. A. K. S. (2023) · Jurnal Keperawatan Soedirman · doi:10.20884/1.jks.2023.18.3.6488 · Cited by 3 · see citing works
“Support from family can increase motivation and prevent stress (Chew et al., 2017), self-management behavior (Kurnia et al., 2017; Yamin & Sari, 2018), especially in dietary behavior compliance (Demilew et al., 2018; Ghimire, 2017).”
BackgroundHansen, S. H., Jensen, T. M., Petersen, G. S., Pouwer, F., Sønderlund, A. L., & Søndergaard, J. (2024) · Trials · doi:10.1186/s13063-024-07949-6 · Cited by 3 · see citing works
Santoso, A., Citraningtyas, T., Viora, E., Gotera, W., Fujiati, I., Lukito, W., Vidiawati, D., Claramita, M., Diatri, H., Prawira, B., et al. (2025) · The Lancet Regional Health - Southeast Asia · doi:10.1016/j.lansea.2025.100605 · Cited by 12 · see citing works
“26,30,56,57 Having a chronic disease in itself may lead to MH conditions if not addressed properly.”
Jeon, B., Chasens, E. R., Luyster, F. S., Callan, J. A., DiNardo, M. M., & Sereika, S. M. (2023) · Sleep And Breathing · doi:10.1007/s11325-023-02819-y · Cited by 4 · see citing works
Psychosocial Interventions by Nurses for Patients with HIV/ AIDS: A Systematic Review
Davoudi, M., Heydari, A., & Manzari, Z. S. (2023) · Journal of Caring Sciences · doi:10.34172/jcs.2023.30726 · Cited by 3 · see citing works
Chew, B., Lai, P. S. M., Sivaratnam, D., Basri, N. I., Appannah, G., Yusof, B. N. M., Thambiah, S. C., Hanipah, Z. N., Wong, P. F., & Chang, L.-C. (2025) · Health Systems & Reform · doi:10.1080/23288604.2024.2417788 · Cited by 4 · see citing works
Self-citationHuang, Y., Xu, Y., & Liu, A. (2021) · Clinical Interventions in Aging · doi:10.2147/cia.s294704 · Cited by 3 · see citing works
“Some patients believe that the use of insulin indicates a serious condition, so the psychological pressure is greater, and the pessimistic mood is more serious.(26,27) Second, if the blood glucose control is not good, the patients may have complications in 5–10 years, which is a threat to the patients, which will inev…”
BackgroundRetractedMedicina Conductual: Avances y Perspectivas
(2021) · Qartuppi eBooks · doi:10.29410/qtp.21.11 · Cited by 3 · see citing works
Soriano, E. C., Fortmann, A. L., Guzman, S. J., Sandoval, H., Spierling Bagsic, S. R., Bastian, A., Antrim, M., Chichmarenko, M., & Philis-Tsimikas, A. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2024.107687 · Cited by 2 · see citing works
Mindfulness and Cardiometabolic Health During Pregnancy: An Integrative Review
Lindsay, K. L., Guo, Y., & Gyllenhammer, L. E. (2024) · Mindfulness · doi:10.1007/s12671-024-02337-2 · Cited by 2 · see citing works
“…well-being interventions, primarily yoga based, can improve measures of glycemic control, including fasting and post-prandial glucose, HbA1c, and measures of adiposity and obesity risk (Chew et al., 2017; Jayawardena et al., 2018; Pascoe et al., 2017; Ramamoorthi et al., 2019; Thind et al., 2017).”
Chae, W. R., Kuhnert, R., Buchmann, M., Sarganas, G., Grams, D., Michalski, N., Otte, C., & Hapke, U. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120210 · Cited by 2 · see citing works
- Authors
- Chew, B. H., Vos, R. C., Metzendorf, M.-I., Scholten, R. J., & Rutten, G. E.
- Affiliations
- Universiti Putra Malaysia (MY)
- University Medical Center Utrecht (NL)
- Heinrich Heine University Düsseldorf (DE)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2017-09-27
- Volume
- 2017
- Issue
- 10
- Pages
- CD011469-CD011469
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC6483710
- OpenAlex
- W2161920207
- Cited by
- 138
- References
- 238
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 21 · 2023: 17 · 2022: 23 · 2021: 22 · 2020: 16 · 2019: 6 · 2018: 8 · 2017: 2 · 2015: 1
- FWCI
- 6.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Universiti Putra Malaysia Institutional Repository (Universiti Putra Malaysia) (acceptedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- National Institute for Health and Care Research (PB-PG-0610-22311)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- diabetes distress, type 2 diabetes, psychological intervention, health-related quality of life, self-efficacy, glycemic control, HbA1c, depression, diabetes self-management education, cognitive behavioral therapy, group intervention, emotion-focused interventions, cognitive intervention, socioeconomic burden, diabetes complications, mortality, adverse events, self-care behavior, blood pressure control
- MeSH terms
- Adult, Depression, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Psychotherapy, Quality of Life, Self Care, Stress, Psychological, Randomized Controlled Trials as Topic
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