Key result
Mindfulness-based stress reduction training reduced urinary albumin excretion to 39 mg/g vs 59 mg/g with standard care at 1 year (p=0.05), though effects were lost after 2 and 3 years.
Why the study?
Current guidelines for type 2 diabetes focus on pharmacological treatment, but the effects of psychosocial interventions on cardiovascular risk factors in patients with early diabetic kidney disease are unclear.
Does an 8-week mindfulness-based stress reduction (MBSR) training reduce urinary albumin excretion and cardiovascular risk factors in patients with type 2 diabetes and early diabetic kidney disease?
RCT (n=110)
Open-label
computer-generated in a 1:1 ratio
Does an 8-week mindfulness-based stress reduction (MBSR) training reduce urinary albumin excretion and cardiovascular risk factors in patients with type 2 diabetes and early diabetic kidney disease?
Absolute Event Rate: 39% vs 59%
p-value: p=0.05
An 8-week mindfulness-based stress reduction program transiently improved urinary albumin excretion, blood pressure, and intima media thickness at 1 year in patients with type 2 diabetes and early kidney disease, but these benefits were not sustained at 3 years.
Short-term ACR and CV marker improvements with MBSR in early DKD require confirmation; leaves open durability and clinical adoption pending larger trials.
Current guidelines for the treatment of type 2 diabetes focus on pharmacological treatment of glucose and cardio-vascular risk factors. The aim of this prospective randomized controlled intervention study was to examine the effects of a psychosocial intervention on clinical endpoints and risk factors in patients with type 2 diabetes and early diabetic kidney disease.110 patients were randomized to receive an 8-week mindfulness-based stress reduction (MBSR) training (n = 53) compared to standard care (n = 57). The study was carried out open-labelled and randomization was performed computer-generated in a 1:1 ratio. Primary outcome of the study was the change in urinary albumin excretion (albumin-creatinine-ratio, ACR); secondary outcomes were metabolic parameters, intima media thickness (IMT), psychosocial parameters and cardiovascular events.89 patients (42 in control group and 47 in intervention group) were analysed after 3 years of follow-up. After 1 year, the intervention group showed a reduction of ACR from 44 [16/80] to 39 [20/71] mg/g, while controls increased from 47 [16/120] to 59 [19/128] mg/g (p = 0.05). Parallel to the reduction of stress levels after 1 year, the intervention-group additionally showed reduced catecholamine levels (p < 0.05), improved 24 h-mean arterial (p < 0.05) and maximum systolic blood pressure (p < 0.01), as well as a reduction in IMT (p < 0.01). However, these effects were lost after 2 and 3 years of follow-up.This is the first study to show that a psychosocial intervention improves cardiovascular risk factors in high risk type 2 diabetes patients. Trial-Registration: NCT00263419 http://clinicaltrials.gov/ct2/show/NCT00263419 TRIAL REGISTRATION: clinicaltrials.gov-Identifier: NCT00263419.
No takes yet. Share an insight, caveat, or question.
Kopf et al. (2014) conducted an RCT in type 2 diabetes and early diabetic kidney disease (n=110). mindfulness-based stress reduction (MBSR) training vs. standard care was evaluated on change in urinary albumin excretion (albumin-creatinine-ratio, ACR) (p=0.05). Mindfulness-based stress reduction training reduced urinary albumin excretion to 39 mg/g vs 59 mg/g with standard care at 1 year (p=0.05), though effects were lost after 2 and 3 years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: