The Effects of Mindfulness on Glycemic Control in People with Diabetes: An Overview of Systematic Reviews and Meta-Analyses

Mindfulness training for cardiovascular health in type 2 diabetes: A critical review

Mindfulness training has gained increasing attention as a potential intervention to improve cardiovascular health, particularly in populations with chronic conditions, such as type 2 diabetes. Given the heightened cardiovascular risk associated with type 2 diabetes, identifying effective non-pharmacological strategies to mitigate these risks is crucial. This critical review assessed the current evidence on the impact of mindfulness training on cardiovascular health in individuals with type 2 diabetes. A comprehensive literature search was conducted using the PubMed database, and studies were selected based on stringent inclusion and exclusion criteria. The search strategy was meticulously designed to filter out high-quality articles and ensure that only the most relevant and rigorous studies were included in the analysis. The findings from this review suggest that while mindfulness training has the potential to improve cardiovascular health in individuals with type 2 diabetes, evidence remains mixed. Some studies have reported significant improvements in cardiovascular markers, such as blood pressure and inflammation, while others have shown limited or no effects. This variability highlights the need for further research to better understand the mechanisms underlying these outcomes and identify the most effective mindfulness interventions for this population. In conclusion, mindfulness training appears to be a promising approach for enhancing cardiovascular health in Type 2 diabetes patients, yet the current evidence is inconclusive. Future research should focus on standardizing mindfulness interventions, conducting larger clinical trials, and exploring the long-term benefits of these interventions on cardiovascular outcomes in high-risk populations.

Mindfulness-Based Interventions and the Hypothalamic-Pituitary-Adrenal Axis: A Systematic Review

BACKGROUND

Numerous studies have evaluated the effect that mindfulness-based interventions (MBIs) have on multiple health outcomes. For its part, stress is a natural response to environmental disturbances and within the associated metabolic responses, alterations in cortisol levels and their measurement in different tissues are a way to determine the stress state of an individual. Therefore, it has been proposed that MBIs can modify cortisol levels.

METHODS AND RESULTS

The objective of this systematic review was to analyze and summarize the different studies that have evaluated the effect of MBIs on cortisol levels. The following databases were consulted: MEDLINE, AMED, CINAHL, Web of Science, Science Direct, PsycINFO, SocINDEX, PubMed, the Cochrane Library and Scopus. The search terms "mindfulness", "mindfulness-based interventions" and "cortisol" were used (and the search was limited to studies from January 1990 to May 2024). In order to reduce selection bias, each article was scrutinized using the JBI Critical Appraisal Checklist independently by two authors. We included those studies with specified intervention groups with at least one control group and excluded duplicate studies or those in which the intervention or control group was not adequately specified. Significant changes in cortisol following MBIs were found in 25 studies, while 10 found no changes. The small sample size, lack of randomization, blinding, and probable confounding and interaction variables stand out in these studies.

CONCLUSION

MBIs have biological plausibility as a means of explaining a positive effect on cortisol levels; however, the weakness of the studies and the absence of robust designs makes it difficult to establish a causal association between both variables.

REGISTRATION NUMBER

INPLASY2024110017.

Examining the Efficacy of Mindfulness-Based Interventions in Treating Obesity, Obesity-Related Eating Disorders, and Diabetes Mellitus

Mindfulness is the practice of focusing one's attention and energy on the present moment with an accepting attitude and an open mindset. Its adoption is increasingly utilized in addressing health concerns, particularly in the realm of nutrition. Mindful eating seeks to adjust disordered eating patterns by cultivating intentional awareness of the physical, mental, and emotional aspects of eating. Mindfulness techniques may involve meditation, breathing exercises, and simply being more attentive in daily activities. Integrating mindfulness into a nutrition strategy may improve digestion, foster a healthier relationship with food, and lead to making better choices aligned with overall well-being. This critical review aims to examine recent prevailing studies on the effects of mindfulness-based interventions (MBI) on weight regulation, eating disorders related to obesity, emotional eating, and diabetes management. For the methods section, the study utilized the Google Scholar and PubMed databases, employing the Medical Subject Headings (MeSH) descriptors. The search included articles published up to September 2024, resulting in a total of 122 articles gathered using various keyword combinations. Results show that out of the 122 studies, 28 articles were common, leaving a total of 94 articles. They included 33 randomized controlled trials (RCTs), 17 systematic reviews and meta-analyses, 11 observational studies, 14 reviews, and 19 others. The findings from these studies demonstrate the positive impact of MBI on conditions such as binge eating disorder, weight loss, emotional eating, and diabetes-related issues. In conclusion, the review supports the growing evidence suggesting that the incorporation of mindfulness can play a crucial role in managing obesity, eating disorders, and their associated consequences. However, further research is necessary to establish a definitive understanding of its effectiveness and how to integrate it into healthcare practices.

The Role of Insulin Within the Socio-Psycho-Biological Framework in Type 2 Diabetes-A Perspective from Psychoneuroimmunology

The interplay between socio-psychological factors and biological systems is pivotal in defining human health and disease, particularly in chronic non-communicable diseases. Recent advancements in psychoneuroimmunology and mitochondrial psychobiology have emphasized the significance of psychological factors as critical determinants of disease onset, progression, recurrence, and severity. These insights align with evolutionary biology, psychology, and psychiatry, highlighting the inherent social nature of humans. This study proposes a theory that expands insulin's role beyond traditional metabolic functions, incorporating it into the Mitochondrial Information Processing System (MIPS) and exploring it from an evolutionary medicine perspective to explore its function in processing psychological and social factors into biological responses. This narrative review comprises data from preclinical animal studies, longitudinal cohort studies, cross-sectional studies, machine learning analyses, and randomized controlled trials, and investigates the role of insulin in health and disease. The result is a proposal for a theoretical framework of insulin as a social substance within the socio-psycho-biological framework, emphasizing its extensive roles in health and disease. Type 2 Diabetes Mellitus (T2DM) with musculoskeletal disorders and neurodegeneration exemplifies this narrative. We suggest further research towards a comprehensive treatment protocol meeting evolutionary expectations, where incorporating psychosocial interventions plays an essential role. By supporting the concept of 'insulin resilience' and suggesting the use of heart rate variability to assess insulin resilience, we aim to provide an integrative approach to managing insulin levels and monitoring the effectiveness of interventions. This integrative strategy addresses broader socio-psychological factors, ultimately improving health outcomes for individuals with T2DM and musculoskeletal complications and neurodegeneration while providing new insights into the interplay between socio-psychological factors and biological systems in chronic diseases.

Effect of mindfulness-based interventions on anxiety, depression, and stress in patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials

Background

Adopting lifestyle interventions is pivotal in coronary artery disease (CAD) management and prevention to amplify cardiovascular and mental well-being. This study aims to quantify the effect of mindfulness-based interventions (MBIs) on anxiety, depression and stress in CAD patients.

Methods

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching four electronic databases (PubMed, CENTRAL, Scopus, and Science Direct) through December 2023. The risk of bias was assessed using the PEDro tool, and the study outcomes were expressed as standard mean difference at 95% CI.

Results

Out of 1838 yielded results, eight RCTs involving 623 participants with a mean age of 56.96 ± 4.89 met the prespecified eligibility criteria. The pooled results showed a statistically significant and beneficial effect of MBIs on CAD patients' mental health status in regards to anxiety (SMD = -0.83; 95% CI [-1.19, -0.46], p < 0.001), depression (SMD = - 0.86; 95% CI [-1.14, -0.58], p < 0.001), and stress (SMD = -0.69; 95% CI [-1.27, -0.12], p = 0.02). The subgroup sensitivity analyses based on the region (Asia vs. Europe) indicated a statistically non-significant subgroup effect of MBIs on anxiety (I 2 = 63.9%, p = 0.10) and depression (I 2 = 25.8%, p = 0.25), and a significant effect on stress (I 2 = 80.0%, p = 0.03). Although the methodological quality of the trials was generally satisfactory, all studies lacked allocation concealment and blinding. Additionally, gender imbalances, and inadequate follow-up may have potentially compromised the validity of the trials.

Conclusion

Mindfulness-based interventions are beneficial for improving CAD patients' anxiety, depression and stress symptoms. Nevertheless, it is imperative to conduct more rigorous and robust studies with an equal gender ratio and long-term follow-up.

Mindfulness and self-regulation intervention for improved self-neglect and self-regulation in diabetic older adults

The current study aimed to assess the impact of combined interventions including mindfulness and self-regulation on self-neglect and self-regulation among Iranian older adults with type 2 diabetes. This was a three-arm cluster randomized controlled trial study conducted among 135 older diabetic patients in Shiraz, Iran. Three urban healthcare centers (clusters) were randomly assigned to three study groups. The intervention groups received either a Self-Regulation-based Intervention Program (SRIP) or a Combined Mindfulness and Self-Regulation Intervention Program (CMSRIP), while the control group received routine care and COVID-19 prevention training. These training programs, which consisted of text and video-based content, were conducted over 24 weeks using WhatsApp as a mobile-based communication platform. Outcomes were measured using the Elder Self-Neglect Scale and Short-Form Self-Regulation Questionnaire at baseline, week 4, and week 16 post-intervention, with data analysis conducted using SPSS 20 software. The CMSRIP led to significantly greater improvement in the score of self-regulation (χ2 = 73.23, P-Value =  < .001) and a reduction in the score of self-neglect (χ2 = 62.97, P-Value =  < .001) at both 4 weeks and 16 weeks after education compared to SRIP. In the control group, there was also a slight improvement. Improvement of self-regulation and reduction of self-neglect in all three groups were less in week 16 than in week 4. Nevertheless, the changes in the intervention groups were significantly better than the control group. This study confirmed a combination of mindfulness-based intervention and self-regulation intervention can effectively improve self-neglect and self-regulation behavior in older patients with type 2 diabetes.Trial registration: This trial (ISRCTN77260130) was retrospectively registered on 28/09/2021.

Therapeutic potential of adiponectin in prediabetes: strategies, challenges, and future directions

Adiponectin, an adipose-derived hormone, plays a pivotal role in glucose regulation and lipid metabolism, with a decrease in circulating adiponectin levels being linked to insulin resistance and prediabetes. This review examines the therapeutic potential of adiponectin in managing prediabetes, elucidating on multiple aspects including its role in glucose and lipid metabolism, influence on insulin sensitivity, and anti-inflammatory properties. Moreover, the paper highlights the latest strategies to augment adiponectin levels, such as gene therapy, pharmacological interventions, dietary modifications, and lifestyle changes. It also addresses the challenges encountered in translating preclinical findings into clinical practice, primarily related to drug delivery, safety, and efficacy. Lastly, the review proposes future directions, underlining the need for large-scale human trials, novel adiponectin analogs, and personalized treatment strategies to harness adiponectin's full therapeutic potential in preventing the transition from prediabetes to diabetes.

Effects of Tai Chi in diabetes patients: Insights from recent research

Tai Chi, a practice that combines elements of both exercise and mindfulness, offers a wide range of health benefits. The body of evidence concerning the impact of Tai Chi on diabetes has recently been growing. This editorial aims to provide a concise summary of the current state of evidence for Tai Chi's effects on individuals with type 2 diabetes (T2D). The review includes 3 randomized controlled trials (RCTs) and 5 systematic reviews and meta-analyses, all of which investigate the effectiveness of Tai Chi on various health outcomes in individuals with T2D. Tai Chi demonstrates a significant effect to enhance glycemic control, lower blood pressure, improve serum lipid profiles, reduce insulin resistance, positively influence obesity-related indices, and improve overall quality of life in individuals with T2D. However, it is noteworthy that recent RCTs have reported inconsistent findings regarding the effects of Tai Chi on glycemic control and insulin resistance. The author also delves into potential mechanisms by which Tai Chi may exert its influence on the human body. Finally, the editorial highlights the critical issues that warrant further exploration in the future.