The effectiveness of psychological interventions on mental health and quality of life in people living with type 1 diabetes: a systematic review and meta-analysis

Efthymiadis, Agathoklis; Bourlaki, Marianthi; Bastounis, Anastasios

Abstract

Background: Living with type 1 diabetes can be associated with significant psychological morbidity, poor glycaemic control, and increased risk for microvascular complications. This systematic review sought to investigate the effects of psychological interventions on depression, anxiety, diabetes-related distress, quality of life, and glycaemic control in people with type 1 diabetes. Methods: Eight electronic databases were searched for published and unpublished randomised controlled trials. Screening, data extraction, and risk of bias assessment (using the Cochrane Collaboration tool for assessing risk of bias 2.0) were independently undertaken by two study authors. The results of the studies were meta-analysed, implementing a random-effects model. The Grading of Recommendations Assessment and Development and Evaluation (GRADE) system was used to determine the confidence in the effect estimates. Results: Twenty studies were identified. Non-significant standardised mean differences (SMD) were found for depression symptoms (SMD = − 0.17, 95% CI [− 0.41, 0.07], p = 0.16) and diabetes-related distress (SMD = − 0.12, 95% CI [− 0.27, 0.04], p = 0.13). Significant SMD was found for quality of life (SMD = 0.27, 95% CI [0.11, 0.42], p = 0.0007). Significant mean difference (MD) was found for HbA1c (MD = − 0.26, 95% CI [− 0.51, − 0.01], p = 0.04). Prespecified subgroup analysis for cognitive behaviour-based interventions showed significant improvement for HbA1c (MD = − 0.23, 95% CI [− 0.44, − 0.02], p = 0.03). Conclusions: Psychological interventions were found to significantly increase quality of life and promote glucose control in people with type 1 diabetes. Depending on their cost-effectiveness, psychological interventions could be incorporated in routine clinical practice for people with type 1 diabetes and concomitant psychological morbidity.

Citation

Efthymiadis, A., Bourlaki, M., & Bastounis, A. (2022). The effectiveness of psychological interventions on mental health and quality of life in people living with type 1 diabetes: a systematic review and meta-analysis. Diabetology International, https://doi.org/10.1007/s13340-021-00564-9

• Journal Article Type: Article
• Acceptance Date: Dec 13, 2021
• Online Publication Date: Jan 28, 2022
• Publication Date: Jan 28, 2022
• Deposit Date: Apr 14, 2022
• Publicly Available Date: Jan 29, 2023
• Journal: Diabetology International
• Print ISSN: 2190-1678
• Electronic ISSN: 2190-1686
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1007/s13340-021-00564-9
• Keywords: Type 1 diabetes; Depression; Anxiety; Diabetes-related distress; Glycaemic control
• Public URL: https://nottingham-repository.worktribe.com/output/7754548
• Publisher URL: https://link.springer.com/article/10.1007/s13340-021-00564-9
• Additional Information: This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://dx.doi.org/0.1007/s13340-021-00564-9