The DOI matches its Crossref record; 232 of the 238 references it cites were found in a registry or an index.
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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“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]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
1 retracted
Group based training for self-management strategies in people with type 2 diabetes mellitus
Deakin, T. A., McShane, C. E., Cade, J. E., & Williams, R. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003417.pub2 · Cited by 862
RetractedMeasuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Self-efficacy: Toward a unifying theory of behavioral change
Bandura, A. (1977) · Psychological Review · doi:10.1037/0033-295x.84.2.191 · Cited by 43,925
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,586
Self-efficacy: the exercise of control
(1997) · Choice Reviews Online · doi:10.5860/choice.35-1826 · Cited by 24,451
Social Cognitive Theory: An Agentic Perspective
Bandura, A. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.1 · Cited by 15,510
Depression and quality of life in older persons: A review
Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A.-S. (2015) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000437299 · Cited by 14,152
Research works printed but not linked: 9
- Taylor E Improving the perceived psychological well-being of seniors with type 2 diabetes through participation in two innovative programs Dissertation Abstracts International: Section B: The Sciences and Engineering 2001 1 99
- Chiu, 2016, Dissemination of evidence-base minimal psychological intervention for diabetes management in Taiwan adults with type 2 diabetes, International Journal of Clinical and Experimental Medicine, 9, 14489
- Dafoulas, 2014, Long-term tele-monitoring of patients with DMT2: preliminary results of the Greek pilot of the renewing health multicenter randomised trial, Diabetes Technology and Therapeutics, 16, A26
- Chew, 2016, Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia, PLoS One, 11, e0152095, 10.1371/journal.pone.0152095 · DOI
- D'Eramo Melkus, 2010, The effect of a diabetes education, coping skills training, and care intervention on physiological and psychosocial outcomes in black women with type 2 diabetes, Biological Research for Nursing, 12, 7, 10.1177/1099800410369825 · DOI
- International Diabetes Federation, 2015, IDF Diabetes Atlas
- Quinones, 2012, Group Visits Focusing on Education for the Management of Chronic Conditions in Adults: A Systematic Review: VA Evidence-based Synthesis Program Reports
- Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan) 2014
- Sperl-Hillen, 2011, Comparative effectiveness of patient education methods for type 2 diabetes: a randomized controlled trial, Archives of Internal Medicine, 171, 2001, 10.1001/archinternmed.2011.507 · DOI
Cited by
Sorted by citations
Items 101–138 of 138
How effective are CBT and CBT ‐based interventions in Type 1 and Type 2 diabetes? An umbrella review
Press, H. S., & Nicklas, L. (2026) · Diabetic Medicine · doi:10.1111/dme.70271 · Cited by 2
“8 DRD evidences a 40% prevalence 9 and is typically measured using the Problem Areas in Diabetes (PAID) 10 and Diabetes Distress Scale (DDS) 6 to distinguish from general stress and co-morbid depressive symptoms.”
Cranney, L., McGill, B., Clare, P. J., & Bauman, A. E. (2022) · Preventive Medicine · doi:10.1016/j.ypmed.2022.107004 · Cited by 2
Nordheim, D. V., Herrick, C., Verdecias, N., Garg, R., Kreuter, M. W., & McQueen, A. (2024) · Diabetes Spectrum · doi:10.2337/ds23-0067 · Cited by 1
Kullman, S. M., Chudyk, A. M., Ferguson, L. J., Beall, J., Hunter, V., Johnson, K., Mallatratt, A., Cabingan, M., Kowalski, K. C., & Strachan, S. M. (2025) · Qualitative Research in Sport Exercise and Health · doi:10.1080/2159676x.2025.2589103 · Cited by 2
“There is a growing recognition of the need for strategies that support both physical and psychological well-being among individuals at risk for T2D (Chew et al. 2017).”
Cheng, H., Wen, T., Lei, Y., Lin, Z., Wang, Q., Chen, J., Wang, Y., & Tang, X. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1796873 · Cited by 1
“People are prone to experiencing various negative emotions when coping with diabetes, such as depression, anxiety, and chronic stress from the demands of rigorous self-management (Perrin et al., 2017; Chew et al., 2017; Hessler et al., 2017).”
Diabetes-related distress and HbA1c: The use of cognitive behavioral therapy
Lerttrakarnnon, P., Robert, G. L., Fakfum, P., & Tunsuchart, K. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85726-0.00029-6 · Cited by 1
Significado das Experiências Emocionais de Pessoas com Diabetes Mellitus do Tipo 2
Lima, É. C. D. C., Lopes, G. S. G., de Sousa, F. D. J. S., & Rolim, I. L. T. P. (2024) · Revista Psicologia e Saúde · doi:10.20435/pssa.v15i1.2359 · Cited by 1
Psychological interventions for depression in people with diabetes mellitus
Tully, P. J., Schutte, N. S., Guppy, M., Garatva, P., Wittert, G., & Baumeister, H. (2025) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd016005 · Cited by 3
Babak, A., Fazli, A., & Keshvari, M. (2025) · Iranian Journal of Nursing and Midwifery Research · doi:10.4103/ijnmr.ijnmr_52_23 · Cited by 1
Rego, F. G. D. M., Picheth, G. F., dos Santos-Weiss, I. C. R., Signorini, L., Volanski, W., do Prado, A. L., Picheth, G., & Anghebem, M. I. (2021) · Brazilian Journal of Health Review · doi:10.34119/bjhrv4n3-102 · Cited by 1
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) · Research Square · doi:10.21203/rs.3.rs-2155724/v1 · Cited by 1
Burch, J., & Hassan-Smith, Z. K. (2018) · Cochrane Clinical Answers · doi:10.1002/cca.1952
Burch, J., & Hassan-Smith, Z. K. (2018) · Cochrane Clinical Answers · doi:10.1002/cca.1951
Individual-Level Intervention Approaches
Snoek, F. J., & Menting, J. (2020) · Springer eBooks · doi:10.1007/978-3-030-33286-0_24
Perceptions and Needs Among Diabetes Patients: A Qualitative Study
Giri, M. K. W., & Putra, A. (2020) · International Conference on Innovative Research Across Disciplines (ICIRAD) · doi:10.2991/assehr.k.200115.033
Living with painful diabetic neuropathy
van Laake‐Geelen, C. C. M. (2021) · Research Publications (Maastricht University) · doi:10.26481/dis.20210923cg
Diabetes Mellitus: A Biopsychosocial Perspective
Hendrieckx, C., de Wit, M., Gray, S., van Duinkerken, E., & Snoek, F. J. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00206-5
Gomille, L. K., Grammes, J., Lehnart, J., Binz, C., Koehn, S., Kubiak, T., & Benecke, A. (2022) · Diabetologie und Stoffwechsel · doi:10.1055/a-1928-9691
“[20] Chew BH, Vos RC, Metzendorf MI et al.”
BackgroundMethodInfluentialالعشری, ح. (2022) · مجلة کلیة الآداب جامعة بورسعید · doi:10.21608/jfpsu.2022.135711.1185
العدد الثانی والعشرون-الجزء الثانی (النسخة الكاملة)
(2022) · مجلة کلیة الآداب جامعة بورسعید · doi:10.21608/jfpsu.2022.268747
Stress Adaptation Model For Uncertain Process Of Diabetes Mellitus Disease
Budiman, M. E. A., Yusuf, A., Suhardiningsih, A. S., & Nihayati, H. E. (2022) · Psychiatry Nursing Journal (Jurnal Keperawatan Jiwa) · doi:10.20473/pnj.v4i2.36574
Kapfhammer, H. (2022) · Springer eBooks · doi:10.1007/978-3-662-65873-4_4
Wong, S. K. W. (2022) · DR-NTU (Nanyang Technological University) · doi:10.32657/10356/163576 · Cited by 1
Zhou, F., Xie, L., Deng, L., Long, K., Guo, C., Yang, T., & Lv, Q. (2023) · Research Square · doi:10.21203/rs.3.rs-2672545/v1
Hà, H. X., Nguyễn, P. T. N., Nguyễn, D. K., & Thái, T. (2023) · Tạp chí Y Dược học Cần Thơ · doi:10.58490/ctump.2023i59.1678 · Cited by 1
Meyrowitsch, D. W., Dang, N.-A. T., Phong, T. V., Nielsen, J., Søndergaard, J., Cuong, N. D., Hiếu, L. M., Vũ, T. K. D., Bygbjerg, I. C., Gammeltoft, T. M., et al. (2024) · Public Health · doi:10.1016/j.puhe.2023.12.034
Liang, Z.-Y., Qin, B., Chen, C., & Zou, T. (2024) · BIO Web of Conferences · doi:10.1051/bioconf/202411103011
“[2-6] Additionally, there is a notable correlation between psychological well-being and DM. [7] This study focuses on individuals aged 60 and above, aiming to explore the association between lifestyle, psychological state, and DM in this age group.”
BackgroundKaraağaç, M., & Acat, Ö. (2024) · Medical Records · doi:10.37990/medr.1516058
‘Not just a diabetic’: Exploring the service needs of young people with diabetes
Patel, K., & Stockton, D. (2023) · Clinical Psychology Forum · doi:10.53841/bpscpf.2023.1.362.34
Prevalence and Impact of Diabetes in Humans During the COVID-19 Pandemic: A Systematic Review
Sharma, S. K., Muduli, D., Parija, S., Pradhan, D., & Panda, N. R. (2024) · International Conference on Signal Processing, Communication, Power and Embedded System (SCOPES) · doi:10.1109/scopes64467.2024.10990569
“Some rules regarding Don’t are avoid hygienic food, maximum use of sugar products etc. Time Line for Diabetes [4] The person affected by diabetes must have to census about the timeline for taking medicine at right time as well as focus on exercise i.e. Yoga Remedies & physical work like morning &…”
Martei, Y. M., Gurram, M., Mokokwe, L. T., Ngwako, N., Kebuang, K., Setlhako, D. I., Vuylsteke, P., Baaitse, B., Segadimo, T., Mosepele, M., et al. (2025) · JCO Global Oncology · doi:10.1200/go-24-00474
Deshmukh, V. C., Phadke, S. S., Agarwal, S., Kalra, S., Sahay, R. K., Viswanathan, V., Chawla, R., Bajaj, S., Phadke, L., Deshmukh, P., et al. (2025) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-025-01506-w
Alvitre, E., & Moubarak, N. (2025) · Recherche en soins infirmiers · doi:10.3917/rsi.159.0064
Schmid-Mohler, G., Hübsch, C., Müller, M., Imhof, R., Jordan, K.-D., Clarenbach, C., Monsch, G.-M., & Yorke, J. (2026) · International Journal of COPD · doi:10.2147/copd.s585311
“The CRED–V1’s relationship with the HADS Anxiety score was non-linear: until a moderate anxiety level, the CRED and HADS anxiety scores correlated positively; however, after that, the CRED score plateaued (Table 3).”
Claudia, M. M., Niba, L. L., & Tendongfor, N. (2026) · AACE Endocrinology and Diabetes · doi:10.1016/j.aed.2026.06.014
Alvarez, M., Herrera, S., Cruz, D., & Castro, A. (2026) · International Journal of Social and Psychological Aspects of Healthcare · doi:10.51847/skztcezvaw
Rafat, M., Rafi, A., Sales, S. S., Naeimi, S., Neshati, A., & Khanchemehr, Y. (2026) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs-173585
Health psychology for more sustainable healthcare: a systems-oriented framework
Grignoli, N., Büchel, J., Favre, O., Keller, R., Isenschmid, M., Martin, T., Petrocchi, S., Soelch, C. M., & Inauen, J. (2026) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2026.2745672
“Diabetes, for example, has benefited from behavioural interventions supporting patient self-care (Chew et al., 2017).”
Metadata
- 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
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
