Editorial: Psychological Interventions to Improve Diabetes Self-Management

Psychological Interventions to Improve Diabetes Self-ManagementDiabetes is an increasingly common condition, and there is frequently a significant burden on the individual with diabetes due to the demands of self-managing a complex long-term condition (1).Many people with diabetes have difficulties in achieving optimal glycaemic control, and psychiatric and psychological factors may present barriers to effective self-management (2).Depression, for example is increasingly being regarded as a risk factor for mortality in diabetes, likely due to the impact of reduced motivation on the active self-management required for good diabetes control (3).Psychological interventions have an important role in the management of suboptimal diabetes care, and there have been a range of studies which have examined various facets of psychological intervention for diabetes optimization (4).There is evidence that specific psychological interventions such as cognitive behaviour therapy (CBT), motivational interviewing and attention control may be effective in reducing diabetes distress and improving diabetes management (5).Upsher et al. conducted a secondary meta-analysis of a pre-existing systematic review and meta-analysis which had included 67 randomized controlled trials (RCTs).The earlier systematic review and meta-analysis found that adults with type 2 diabetes (T2D) who received a psychological intervention experienced a significant reduction in HbA1c compared with those who did not receive the intervention (5).This secondary analysis was conducted with a view to identifying the "active ingredients" of these psychological interventions, to inform the development of future interventions.This paper reviewed the psychological interventions in studies included in the pre-existing review and identified the behaviour change techniques (BCTs) utilised in the individual studies.This study identified that 'social support' (n=50), 'problem solving' (n=38) and 'goal setting' (n=30) were the most frequently used BCTs, and all were associated with significant improvements in glycaemic control (HbA1c).On meta-analysis there were no significant associations between HbA1c and type of psychological intervention (p=0.84), or of the frequency of BCTs occurring within the intervention (p=0.29).This study identified that social support, problem solving, and goal setting may have potential in developing future psychological interventions for people with T2D.