1605-P: Synchronous Video-Conference–Based Mindfulness-Based Stress Reduction vs. Stress Management Education for Uncontrolled Diabetes: A Randomized Trial

Introduction and Objective: Adults with diabetes often experience high stress that can impair self-management and glycemia. We tested whether video-conference-based mindfulness meditation training (Mindfulness-Based Stress Reduction [MBSR]) improves HbA1c compared with an active Stress Management Education (SME) control in adults with uncontrolled diabetes. Methods: Randomized trial. Adults (≥18 years) with diabetes and elevated stress were randomized to synchronous video-conference-based MBSR or SME with parallel schedules and assigned home practice. The primary outcome was change in home HbA1c (A1CNow) from baseline to 6 months, analyzed using a linear mixed-effects model (fixed effects: arm, visit, baseline insulin use, arm × visit interaction; random effects: participant and cohort). Results: A total of 309 participants were randomized (MBSR n=154; SME n=155); mean age was 54.6 ± 12 years and 67% were female. Baseline HbA1c mean was 8.50% (95% CI 8.23 to 8.77) in MBSR and 8.60% (8.33 to 8.87) in SME. At 6 months, HbA1c decreased in both groups: −0.35% (−0.60 to −0.10) with MBSR and −0.36% (−0.60 to −0.11) with SME; difference in changes (SME−MBSR) −0.01% (−0.36 to 0.34), p=0.96. Perceived stress (PSS-10) decreased more with MBSR than SME from baseline to 2 months: −3.2 (−4.3 to −2.1) vs −1.6 (−2.7 to −0.6); difference in changes 1.6 (0.1 to 3.1), p=0.04; at 6 months, changes were −2.8 (−3.9 to −1.7) vs −2.0 (−3.1 to −0.9); difference in changes 0.8 (−0.7 to 2.4), p=0.30. Diabetes distress improved between baseline and 6 months: −0.34 (−0.47 to −0.22) vs −0.39 (−0.51 to −0.27); difference in changes −0.05 (−0.22 to 0.12), p=0.59. Conclusion: Synchronous video-conference-based mindfulness meditation training (MBSR) did not differentially improve HbA1c compared with an active control, but produced greater reductions in perceived stress. These findings inform scalable approaches to stress in adults with diabetes and support future work exploring mechanisms linking stress reduction and metabolic outcomes. Disclosure N. Raja-Khan: None. A. Kunselman: Stock/Shareholder; Current; Merck & Co., Inc. E. Wasserman: None. J. Greeson: None. D.A. McCown: None. Funding National Institutes of Health (R01 DK119379)