We have known for years that meditation and relaxation exercises have been used to increase one’s sense of peace and calm. However, more and more links are being discovered between these techniques and physical, mental, emotional and spiritual health. 

People living with diabetes have to make 180 extra decisions each day, and experience significant psychological pressure to ‘get it right’. Eventually this can lead to diabetes distress, the feelings of frustration, angst and overwhelm, and this can makes diabetes management even more of a challenge. It’s a real chicken-and-egg situation. 

However, if you can dial down the emotional stress and improve psychological wellbeing, will this assist with improving the amount of time you can achieve glucose levels within the healthy range suggested to you by your health care team? 

Studies into mindfulness

Reviewing just a handful of quality trials into mindfulness-based interventions in diabetes showed various approaches significantly reduced self-monitored levels of blood glucose and HbA1c. 

Additional benefits have been observed in the areas of coping skills, sleep quality, mood and quality of life. 

Diabetes distress can be experienced as situation-based, short-term irritation and frustration. But when long-term stress is endured, it may lead to forgetfulness, lethargy, self-isolation, appetite changes, and less motivation to manage diabetes to the best of your ability.  

Stress increases sympathetic nervous system activity, that’s also known as the fight or flight mechanism. A stream of hormones are released from the adrenal glands increasing, among other things, blood glucose levels. 

One study of 30 volunteers used a randomly designed, pre and post-test to determine whether people with type 2 diabetes could reduce their HbA1c levels using mindfulness-based cognitive therapy sessions. They underwent one 90-minute session each week for 10 weeks. A control group was not given any therapy. Initially both groups were statistically similar; however, towards the end of the trial the therapy group showed a HbA1c reduction from 9.7 to 9.0%. 

In another randomised, pre- and post-study of 60 people aged 30 to 60 years, who had been seeing a health care team for their diabetes for five to 10 years, was undertaken. This trial lasted 18 months and involved the participants performing daily yoga meditation for 10 minutes every morning and evening. Pathology showed an increase in parasympathetic hormones (the nervous system responsible for rest and digest). The average drop in HbA1c in this group was 0.86%.  Another similar trial of 132 people living with diabetes lasted three months. Volunteers underwent mindfulness training in a double-blind trial which revealed significant reductions in both fasting blood glucose and HbA1c. 

A technique combining relaxing yoga stretches, breathing and concentration exercises was trialled with a group of 30 to 65-year-old people living with type 2 diabetes. For eight minutes they assumed yoga postures, then relaxed for two minutes, and then meditated for 13 minutes. The exercise lasted for a total of 23 minutes, and including five minutes of silent work for the final five minutes. Again significant reductions in HbA1c levels were shown to result with the mean reduction being 0.49%. 

Thirty two people, living with type 1 diabetes for an average of 12 years, trialled mindfulness meditation for six months. They practised the technique for at least 20 minutes each day. Screening was conducted pre and post-trial. A significant reduction was shown in mean HbA1c from 9.3 to 8.4%. No change was found for those not practising the meditation routine. Mean fasting blood glucose also reduced from an average of 12.4 to 10.1mmol/L. This trial also measured diabetes distress and found the intervention group improved statistically in this area as well. In fact, the diabetes distress score of the meditating volunteers also significantly reduced. 

In conclusion

Research into the connection of mindfulness meditation and relaxation techniques as part of diabetes management is on the rise. We are learning about links with fasting blood glucose, HbA1c, and diabetes distress scores. Although many of these trials do not include long-term interventions involving high numbers of participants the results are promising.

If you feel this may be of benefit to your diabetes self-management please discuss it with your GP. They may refer you to a psychologist on either a GP Management and Team Care Arrangement Plan or a Mental Health Plan so you can explore this with an experienced and qualified health professional.  

Further information

The following factsheets may be of interest to you. 

Diabetes distress  

Diabetes and anxiety 

Diabetes and depression 

Adjusting to life with diabetes 

Constance Russell, Registered Nurse and Credentialled Diabetes Educator