Mindful Diabetes for Less Stress and Better A1C
More and more studies show that mindfulness and meditation are helping people to manage stress. The U.S. Department of Veterans Affairs is working with veterans who have some of the most severe problems, and they seem to be in the lead in making use of these tools.
But not until now have mindfulness and meditation been studied specifically with veterans who have diabetes. A preliminary study just reported at the annual meeting of the American Association of Diabetes Educators presented some dramatic results that should be applicable to anyone who has diabetes.
Previous studies of four forms of mindfulness and meditation showed that they have helped veterans deal with posttraumatic stress disorder (PTSD), which can occur after a traumatic event like war, assault, or disaster. While mindfulness and meditation are essential components of Buddhism and Hinduism, mainstream Western culture has now absorbed them. A pilot study of loving-kindness meditation produced promising and moving results. Mantram meditation, yoga, and transcendental meditation each have helped groups of veterans to manage PTSD.
Since meditation and mindfulness help veterans with severe emotional problems, it's not surprising that they also help the general population. Ever since Dr. Jon Kabat-Zinn developed the mindfulness-based stress reduction (MBSR) program at the University of Massachusetts Medical Center in the 1970s, it has been studied in about 100 randomized controlled trials. In June, I reported here on one study showing that mindfulness and meditation have helped people with diabetes live happier lives.
Now, the new study of veterans with diabetes shows that mindfulness training can indeed reduce stress. But it goes further and into the specific goal that is crucial to diabetes management.
Dr. Monica DiNardo, a health scientist at the VA Pittsburgh Healthcare System, presented the study on August 6, 2014. A Certified Diabetes Educator, she presented data on 28 veterans with either type 1 or type 2 diabetes who were included in the Mindful Stress Reduction in Diabetes Education (Mind-STRIDE) study. The results of the study are not available online, but Dr. DiNardo shared her PowerPoint presentation with me.
Mindfulness is simply the nonjudgmental awareness of the present moment. It's simple, but takes practice.
Mindfulness training included as part of routine diabetes self-management education for veterans was associated with a 41 percent decrease in diabetes-related distress. That's substantial, but the second finding that Dr. DiNardo presented really caught my attention. This was the reduction in the A1C levels, the best measurement we have showing how well we are managing our diabetes.
When the study started, the typical A1C level of the 28 participants was 8.3 percent. Three months later, when the study concluded, it had dropped to 7.3 percent.
"It is important to note that this was a preliminary feasibility study and though the findings are promising they are not generalizable," Dr. DiNardo told me. "We are planning further studies to take an expanded look and hope we will have the opportunity to follow up on several interesting aspects of what we found."
The program began by showing what stress does to our body and how mindfulness training can help reduce it. The program then provided practical training in mindful stress reduction techniques in which the participants learned how to be more present, improve their body awareness, separate their thoughts, emotions, and body sensations, and develop focused attention. The participants practiced the techniques of focused breathing and mindful movement for 15 minutes every day for three months, and received guidance to continue the exercises at home.
"The veterans were much more receptive to mindfulness training than we anticipated," Dr. DiNardo says. "We were surprised at the dramatic decrease in diabetes-related stress. The veterans said the more mindful they were, the better they were able to manage their diabetes."
Even though I didn't participate in this Mind-STRIDE study, I know that it works. I know it because for many years I have been practicing mindfulness and meditation as well as I can. I know that I have much less stress and a much better A1C level than I had earlier.
Managing our stress is one of the three primary legs of diabetes control. We talk all the time about the other two: good diet and physical activity. But only when we also manage our stress can we be sure to be in control of our diabetes and of our life.