Cognitive behavioral treatment to improve psychological adjustment in people recently diagnosed with type 2 diabetes: Psychological treatment in type 2 diabetes

Héctor Velázquez-Jurado; Athena Flores-Torres; Liliana Pérez-Peralta; Edgar Salinas-Rivera; Marianne Daniela Valle-Nava; Denise Arcila-Martinez; Sergio Hernández-Jiménez; CAIPaDi Study Group

doi:10.1080/21642850.2023.2179058

Cognitive behavioral treatment to improve psychological adjustment in people recently diagnosed with type 2 diabetes: Psychological treatment in type 2 diabetes

Health Psychol Behav Med. 2023 Feb 19;11(1):2179058. doi: 10.1080/21642850.2023.2179058. eCollection 2023.

Authors

Héctor Velázquez-Jurado^{1

2}, Athena Flores-Torres², Liliana Pérez-Peralta¹, Edgar Salinas-Rivera³, Marianne Daniela Valle-Nava^{1

2}, Denise Arcila-Martinez¹, Sergio Hernández-Jiménez¹; CAIPaDi Study Group

Affiliations

¹ Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
² Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
³ Department of Educational Psychology, National Pedagogic University (UPN), Mexico City, Mexico.

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic disease that affects a person's general well-being. Current evidence sets an association between psychological well-being and controlled metabolic parameters. People newly diagnosed with T2DM show higher prevalence of depression and anxiety symptoms. Cognitive behavioral therapy (CBT) has effectively improved psychological adjustment, but most studies do not specifically address recently diagnosed people nor usually include long-term follow-up measures.

Objective: We sought to assess changes in psychological variables in people with newly diagnosed diabetes who received a cognitive-behavioral intervention, within a comprehensive care program.

Method: 1208 adults with T2DM (≤5 years) who attended a national health institute in Mexico received a cognitive-behavioral intervention aimed at improving quality of life and reducing emotional distress that often interferes with diabetes control, as well as evaluating cognitive and emotional resources and social support. Measures of quality of life, diabetes-related distress, anxiety and depression questionnaires were compared at pre-test, post-test and follow up using Friedman's ANOVAs. Multiple logistic regression models evaluated glycosylated hemoglobin (HbA1c) and triglycerides control at post-test and follow up.

Results: Questionnaire measures and metabolic variables significantly decreased symptomatology at post-test and these changes maintained at follow-up. Significant associations were found between quality-of-life scores and HbA1c and triglycerides levels in post-test and follow-up. Diabetes-related distress scores increased the odds of having adequate HbA1c control at post-test.

Conclusion: This study contributes to the evidence on the importance of considering psychological factors as part of comprehensive diabetes care to improve quality of life and emotional burden and facilitate the achievement of metabolic goals.

Keywords: Psychological evaluation; behavioral change; diabetes self-management; diabetes-related distress; quality of life.

Grants and funding

This work was supported by the CAIPaDi program which received grants from Astra Zeneca, Fundación Conde de Valenciana, Novartis, Consejo Nacional de Ciencia y Tecnología (‘‘Proyectos de Desarrollo Científico para Atender Problemas Nacionales 2013 project 214718), Nutrición Médica y Tecnología, NovoNordisk, Boehringer Ingelheim, Dirección General de Calidad y Educación en Salud, Eli Lilly, Merck Serono, MSD, Silanes, Chinoin and Carlos Slim Health Institute.