Effects of psychotherapy interventions on glycemic control and weight loss in adults with type 2 diabetes mellitus: a systematic review and meta-analysis.

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease which requires sustained lifestyle modifications. Psychological and diabetes-related distress may affect treatment adherence. Psychotherapy-based approaches are being incorporated into diabetes care, but their impact on glycemic control and anthropometric outcomes has not been clearly understood. We examined the effects of psychotherapy-based interventions on glycemic control (HbA1c), body weight and body mass index (BMI) in adults with T2DM across fifty-two studies which were included in the analysis. Psychotherapy-based interventions showed a significant reduction in HbA1c levels, with greatest effect at 3-month follow-up (MD - 0.53%, 95% CI - 0.80 to -0.25). Among anthropometric outcomes, weight loss was significantly reduced at 12 months (MD -3.58, 95% CI -5.62 to -1.53), whereas BMI showed less consistent effects. Overall, psychotherapy-based interventions resulted in consistent improvements in HbA1c and longer-term reductions in body weight in adults with T2DM. The earlier improvements in HbA1c may reflect the influence of psychological support leading to changes in dietary and diabetes self-management behaviors, whereas anthropometric changes require sustained behavioral modification.