One-Year Follow-Up of a Randomized Controlled Trial Piloting a Mindfulness-Based Group Intervention for Adolescent Insulin Resistance.

Lauren B Shomaker,Jordan Quaglia,Shelly K Annameier,Bernadette Pivarunas,Kirk Warren Brown,Patricia Broderick,Lauren Gulley,Christopher Bell

doi:10.3389/fpsyg.2019.01040

Abstract

IntroductionTo explore if a brief mindfulness-based intervention (MBI) leads to sustained, improved clinical outcomes in adolescents at-risk for type 2 diabetes (T2D).MethodsParticipants were 12–17y girls with overweight/obesity, elevated depression symptoms, and T2D family history participating in a randomized, controlled pilot trial of a six-session MBI vs. cognitive-behavioral therapy (CBT) group. At baseline and 1-year, mindfulness, depression, insulin resistance (IR), and body composition were assessed with validated instruments.ResultsOne-year retention was 71% (n = 12) in MBI; 81% (n = 13) in CBT. At 1-year, depression decreased (Cohen’s d = 0.68) and IR decreased (d = 0.73) in adolescents randomized to MBI compared to those in CBT. There were no significant between-condition differences in mindfulness, adiposity, or BMI.DiscussionOne-year outcomes from this randomized, controlled pilot trial suggest that brief MBI may reduce depression and IR in at-risk adolescents. Replication and exploration of mechanisms within the context of a larger clinical trial are necessary.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT02218138.

Highlights

To explore if a brief mindfulness-based intervention (MBI) leads to sustained, improved clinical outcomes in adolescents at-risk for type 2 diabetes (T2D)
Adolescents in MBI decreased baseline-to-1-year insulin resistance (IR) compared to stable IR in cognitive-behavioral therapy (CBT), with a moderate, between-condition effect size (d = 0.73, p < 0.01)
Consistent with previous findings (Shomaker et al, 2017), adolescents at-risk for T2D with elevated depression had greater decreases in depression symptoms 1-year following a six-session MBI, as compared to adolescents who were randomized to CBT

Summary

Introduction

To explore if a brief mindfulness-based intervention (MBI) leads to sustained, improved clinical outcomes in adolescents at-risk for type 2 diabetes (T2D). Mindfulness-based interventions (MBIs) have been utilized for managing common, chronic health conditions like type 2 diabetes (T2D). Randomized controlled trials in adults with diabetes show that MBIs. Mindfulness for Adolescent Insulin Resistance have small-to-moderate effects for decreasing depression and heterogeneous effects for glycemic control (Abbott et al, 2014). MBIs are designed to address depression by increasing frequency of mindful states, thereby providing individuals with more effective ways of coping with stressors that accompany major health conditions. Intervening to increase mindfulness and decrease depression in adolescents at-risk for T2D is anticipated to ameliorate IR. MBIs may have salutary effects on IR through a number of mechanisms, including decreases in depression and increases in effective self-regulation of attention, stress, emotion, and behaviors important for IR, such as emotional eating (Lyons and Zelazo, 2011)

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