Abstract
BackgroundApproximately 20-40% of outpatients with diabetes experience elevated levels of emotional distress, varying from disease-specific distress to general symptoms of anxiety and depression. The patient's emotional well-being is related to other unfavorable outcomes, like reduced quality of life, sub-optimal self-care, impaired glycemic control, higher risk of complications, and increased mortality rates. The purpose of this study is to test the effectiveness of a new diabetes-specific, mindfulness-based psychological intervention. First, with regard to reducing emotional distress; second, with respect to improving quality of life, dispositional mindfulness, and self-esteem of patients with diabetes; third, with regard to self-care and clinical outcomes; finally, a potential effect modification by clinical and personality characteristics will be explored.Methods/DesignThe Diabetes and Mindfulness study (DiaMind) is a randomized controlled trial. Patients with diabetes with low levels of emotional well-being will be recruited from outpatient diabetes clinics. Eligible patients will be randomized to an intervention group or a wait-list control group. The intervention group will receive the mindfulness program immediately, while the control group will receive the program eight months later. The primary outcome is emotional distress (anxiety, stress, depressive symptoms), for which data will be collected at baseline, four weeks, post intervention, and after six months follow-up. In addition, self-report data will be collected on quality of life, dispositional mindfulness, self-esteem, self-care, and personality, while complications and glycemic control will be assessed from medical files and blood pressure will be measured. Group differences will be analyzed with repeated measures analysis of covariance.The study is supported by grants from the Dutch Diabetes Research Foundation and Tilburg University and has been approved by a medical ethics committee.DiscussionIt is hypothesized that emotional well-being, quality of life, dispositional mindfulness, self-esteem, self-care, and blood pressure will improve significantly more in the mindfulness group compared to the control group. Results of this study can contribute to a better care for patients with diabetes with lowered levels of emotional well-being. It is expected that the first results will become available in 2012.Trial registrationDutch Trial Register NTR2145.
Highlights
20-40% of outpatients with diabetes experience elevated levels of emotional distress, varying from disease-specific distress to general symptoms of anxiety and depression
It is hypothesized that emotional well-being, quality of life, dispositional mindfulness, self-esteem, selfcare, and blood pressure will improve significantly more in the mindfulness group compared to the control group
The present article provides an outline of the background and design of the Diabetes and Mindfulness (DiaMind) study
Summary
20-40% of outpatients with diabetes experience elevated levels of emotional distress, varying from disease-specific distress to general symptoms of anxiety and depression. For all patients with diabetes, appropriate glycemic control by means of adequate self-management is required in order to prevent or delay the development of diabetes complications: macrovascular complications (e.g. coronary artery disease) and microvascular complications (i.e. nephropathy, retinopathy, and neuropathy). This selfmanagement consists for example of a healthy diet, physical exercise, frequent assessment of the blood glucose levels, and (in many cases) the use of medication to control the blood glucose (an oral hypoglycemic agent and/ or insulin)[3]
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