Facilitating Healthy Coping in Patients With Diabetes: A Systematic Review
Open accessAbstract
PURPOSE: The purpose of this study is to summarize recent literature on approaches to supporting healthy coping in diabetes in 2 specific areas: (1) the impact of different approaches to diabetes treatment on healthy coping and (2) the effectiveness of interventions specifically designed to support healthy coping. METHODS: A PubMed search identified 129 articles published August 1, 2006, to April 30, 2011, addressing diabetes in relation to emotion, quality of life, depression, adjustment, anxiety, coping, family therapy, behavior therapy, psychotherapy, problem solving, couples therapy, or marital therapy. RESULTS: Evidence suggests that treatment choice may significantly influence quality of life, with treatment intensification in response to poor metabolic control often improving quality of life. The recent literature provides support for a variety of healthy coping interventions in diverse populations, including diabetes self-management education, support groups, problem-solving approaches, and coping skills interventions for improving a range of outcomes; cognitive behavior therapy and collaborative care for treating depression; and family therapy for improving coping in youths. CONCLUSIONS: Healthy coping in diabetes has received substantial attention in the past 5 years. A variety of approaches show positive results. Research is needed to compare the effectiveness of different approaches in different populations and determine how to overcome barriers to intervention dissemination and implementation.
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Self-management behaviours including insulin injection, self-monitoring of blood glucose, regulated mealtimes, exercise, problem-solving, coping and risk-reduction are positively correlated with good glycaemic control (HbA1c).
“Together, these behaviours have been found to be positively correlated with good glycaemic control (HbA1c), reduced diabetes-related complications and improved quality of life (QoL).2 3”
From Acceptance and commitment therapy (ACT) for adult type 1 diabetes management: Study protocol for a randomised controlled trial (2018) · cites this paper as [3]
In Results, Part 2 (page not provided), the review reports that self-management education improved quality of life in several studies and suggests problem-solving may benefit self-care and glycaemic control. It does not establish a positive HbA1c correlation for the full list of behaviours or link them collectively to reduced diabetes-related complications. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSelf-management behaviours including insulin injection, self-monitoring of blood glucose, regulated mealtimes, exercise, problem-solving, coping and risk-reduction are positively correlated with reduced diabetes-related complications.
“Together, these behaviours have been found to be positively correlated with good glycaemic control (HbA1c), reduced diabetes-related complications and improved quality of life (QoL).2 3”
From Acceptance and commitment therapy (ACT) for adult type 1 diabetes management: Study protocol for a randomised controlled trial (2018) · cites this paper as [3]
The Results section (Part 2; page not provided) reports improved quality of life following some diabetes self-management education interventions and suggests that problem-solving may benefit glycemic control. The passages do not establish that the listed behaviours are correlated with reduced diabetes-related complications; the Discussion likewise addresses control and quality of life, not complication rates. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSelf-management behaviours including insulin injection, self-monitoring of blood glucose, regulated mealtimes, exercise, problem-solving, coping and risk-reduction are positively correlated with improved quality of life.
“Together, these behaviours have been found to be positively correlated with good glycaemic control (HbA1c), reduced diabetes-related complications and improved quality of life (QoL).2 3”
From Acceptance and commitment therapy (ACT) for adult type 1 diabetes management: Study protocol for a randomised controlled trial (2018) · cites this paper as [3]
In Results, Part 2 (page not supplied), the review reports improved quality of life with some diabetes self-management education interventions, particularly those involving insulin and diet. It does not establish a positive correlation between every listed behaviour and quality of life; nor do the cited passages establish reduced diabetes-related complications for those behaviours. (LLM, conf=0.86)
Experimental — accuracy not yet measuredDiabetes self-management education and support is associated with positive coping behaviors.
“DSMES is associated with improved diabetes knowledge and self-care behaviors (17), lower A1C (17-21), lower selfreported weight (22), improved quality of life (19,23,24), reduced all-cause mortality risk (25), positive coping behaviors (5,26), and reduced health care costs (27)(28)(29).”
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 [26]
Diabetes self-management education and support interventions tailored to individual needs and preferences were associated with better outcomes.
“Better outcomes were reported for DSMES interventions that were more than 10 h over the course of 6-12 months (20), included ongoing support (14,32), were culturally (33)(34)(35) and age appropriate (36,37), were tailored to individual needs and preferences, addressed psychosocial issues, and incorporated behavioral strategies (15,26,38,39).”
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 [26]
Diabetes self-management education and support interventions addressing psychosocial issues were associated with better outcomes.
“Better outcomes were reported for DSMES interventions that were more than 10 h over the course of 6-12 months (20), included ongoing support (14,32), were culturally (33)(34)(35) and age appropriate (36,37), were tailored to individual needs and preferences, addressed psychosocial issues, and incorporated behavioral strategies (15,26,38,39).”
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 [26]
Diabetes self-management education and support interventions incorporating behavioral strategies were associated with better outcomes.
“Better outcomes were reported for DSMES interventions that were more than 10 h over the course of 6-12 months (20), included ongoing support (14,32), were culturally (33)(34)(35) and age appropriate (36,37), were tailored to individual needs and preferences, addressed psychosocial issues, and incorporated behavioral strategies (15,26,38,39).”
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 [26]
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- Authors
- Thorpe, C. T., Fahey, L. E., Johnson, H., Deshpande, M., Thorpe, J. M., & Fisher, E. B.
- Affiliations
- University of Wisconsin–Madison (US)
- Corresponding author
- Thorpe, Carolyn T.
- Venue
- The Diabetes Educator
- Publisher
- SAGE Publications
- Published
- 2012-10-16
- Volume
- 39
- Issue
- 1
- Pages
- 33-52
- ISSN
- 0145-7217 (ISSN-L)
- 1554-6063
- PMC
- PMC3549032
- OpenAlex
- W1988161589
- Cited by
- 155
- References
- 96
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 3 · 2023: 10 · 2022: 10 · 2021: 17 · 2020: 19 · 2019: 13 · 2018: 10 · 2017: 13 · 2016: 13 · 2015: 19 · 2014: 13 · 2013: 4 · 2012: 1
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Science of Diabetes Self-Management and Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000427)
- National Center for Research Resources (UL1RR025011)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
- Keywords
- diabetes mellitus, coping, diabetes self-management education, support groups, problem solving, cognitive behavioral therapy, collaborative care, depression, anxiety, quality of life, family therapy, adolescents, psychotherapy, treatment intensification, metabolic control
- MeSH terms
- Adaptation, Psychological, Anxiety, Depression, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Health Promotion, Humans, Male, Patient Acceptance of Health Care, Problem Solving, Quality of Life, Self Care, Cognitive Behavioral Therapy
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