Effectiveness of cognitive-behavioural therapy on glycaemic control and psychological outcomes in adults with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

AIM

Diabetes is a chronic progressive condition presenting physical, social and psychological challenges that increase the risk of comorbid mental health problems. Cognitive-behavioural therapy (CBT) is effective in treating a variety of psychological disorders, and may potentially improve glycaemic control and psychological outcomes in diabetes. This systematic review and meta-analysis aims to establish the effectiveness of CBT on glycaemic control and comorbid diabetes-related distress, depression, anxiety and quality of life in the short, medium and longer term among adults with diabetes.

METHOD

An electronic search was conducted in PubMed, Embase, MEDLINE, PsycINFO, CINAHL, Web of Knowledge, Cochrane Central Register of Controlled Trials and references in reviews. Twelve randomized controlled trials (RCTs) were identified that evaluated the effectiveness of CBT on at least one of: glycaemic control, diabetes-related distress, anxiety, depression or quality of life in adults with Type 1 or Type 2 diabetes. The Cochrane Risk of Bias Tool and Review Manager version 5.3 were used for risk of bias assessment and meta-analysis, respectively.

RESULTS

CBT is effective in reducing short-term and medium-term glycaemic control, although no significant effect was found for long-term glycaemic control. CBT improved short- and medium-term anxiety and depression, and long-term depression. Mixed results were found for diabetes-related distress and quality of life.

CONCLUSION

CBT is beneficial in improving depression for adults with diabetes. It may have benefits for improving glycaemic control and other aspects of psychological health, although the findings are inconclusive.

Short communication: effect of saccharomyces cerevisiae supplementation on some biomarkers of oxidative stress in weaned rabbits during the hot-dry season

<p>A feeding trial was conducted to evaluate the effect of Saccharomyces cerevisiae (SC) supplementation on some biomarkers of oxidative stress in rabbits during the hot-dry season (temperaturehumidity index: 33.2±0.9oC). Sixty healthy weaned crossbred rabbits, aged between 5-6 wk with live weight of 612.7±60.8 g (mean±standard deviation) were used. The rabbits were divided into 5 treatment groups; SC0 receiving a control diet without supplementation of SC, and SC2, SC4, SC6 and SC8 receiving the control diet supplemented with SC at the rate of 2, 4, 6 and 8×109 colony forming units/kg, respectively. The activity of total superoxide dismutase and malonaldehyde in serum were not significantly affected, but serum catalase concentration rose (P&lt;0.05) as the SC inclusion level increased. Although further studies are required, baker’s yeast containing SC could help ameliorate the adverse effects of heat stress in rabbits.</p><p> </p>