Effect of group cognitive behavioural therapy on psychological stress and blood glucose in people with type 2 diabetes mellitus: a community-based cluster randomized controlled trial in China
Abstract
Abstract Objective To assess whether group cognitive behavioural therapy (GCBT) delivered by general practitioners reduces anxiety and depression and improves glycaemic levels in adults with type 2 diabetes mellitus. Methods We conducted a community‐based cluster randomized controlled trial in adults with type 2 diabetes mellitus from 48 communities in China. Participants received either GCBT plus usual care (UC) or UC only. General practitioners were trained in GCBT before intervention in the intervention group. The primary outcome was glycated haemoglobin (HbA 1c ) concentration. Outcome data were collected from all participants at baseline, 2 months, 6 months and 1 year. The secondary outcomes were depression (Patient Health Questionnaire‐9; PHQ‐9) and anxiety (General Anxiety Disorder questionnaire; GAD‐7). Results The GCBT group showed greater improvement in GAD‐7 and PHQ‐9 scores, respectively, than the UC group after 2 months post‐baseline ( T = −6.46, p < 0.0001; T = −5.29, p < 0.001), 6 months ( T = −4.58, p < 0.001; T = −4.37, p < 0.001) and 1 year post‐intervention ( T = −3.91, p < 0.001; T = −3.57, p < 0.001). There was no difference in HbA 1c values between the GCBT and UC groups at 2 months while the values were lower in the GCBT group at 6 months and 1 year ( T = −6.83, p < 0.001; T = −4.93, p < 0.001, respectively). Subgroup analysis indicated a long‐term effect of GCBT only for mild and moderate anxiety and mild depression groups. Similarly, HbA 1c values reduced only in the mild and moderate anxiety and the mild depression groups. Conclusions General practitioners can deliver GCBT interventions. GCBT plus UC is superior to UC for reducing mild/moderate anxiety and depression, and improving glycaemic levels. Trial registration Chinese clinical trials registration (ChiCTR‐IOP‐16008045).
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Cognitive behavioral and mindfulness-based therapies are successful therapeutic approaches for people with diabetes and psychosocial concerns.
“Successful therapeutic approaches include cognitive behavioral (330,332,348,349) and mindfulness-based therapies (346,350,351).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [330]
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“Cognitivebehavioral therapy (CBT) has been recommended as the preferred non-drug therapy for anxiety and depression in adults [11] and has been implemented successfully for the psychological treatment of chronic diseases, such as chronic obstructive pulmonary disease [12], asthma [13], and diabetes [14].”
BackgroundMethodSelf-citation
- Authors
- Xu, C., Dong, Z., Zhang, P., Chang, G., Xiang, Q., Zhang, M., Zhou, J., Qiao, C., Yang, Q., Qin, Y., & Lou, P.
- Affiliations
- Xuzhou Cancer Hospital (CN)
- Department of Control and Prevention of Chronic Non‐communicable Diseases Xuzhou Center for Disease Control and Prevention Xuzhou Jiangsu China
- Jiangsu Provincial Center for Disease Control and Prevention (CN)
- Corresponding author
- Qin, Yu
- Lou, Peian
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2020-12-20
- Volume
- 38
- Issue
- 2
- Pages
- e14491-e14491
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W3111898324
- Cited by
- 27
- References
- 35
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 5 · 2023: 7 · 2022: 7
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- group cognitive behavioral therapy, type 2 diabetes, psychological stress, anxiety, depression, HbA1c, glycemic control, general practitioners, community-based intervention, primary care
- MeSH terms
- Patient Health Questionnaire, Aged, Anxiety, China, Depression, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Psychotherapy, Group, Stress, Psychological, Cognitive Behavioral Therapy, Linear Models, Treatment Outcome, General Practitioners
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