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Transforming Diabetes Management: How Meditation and Mindful Practices Revolutionize Diabetes Care

May 15, 2025 – by Era Martin

Introduction

Diabetes is a chronic metabolic disorder that necessitates continuous management to maintain blood sugar levels within a healthy range. Over time, diabetes can lead to complications affecting the circulatory, immune, and nervous systems. For many patients, the burden of self-care can become overwhelming, contributing to emotional and psychological challenges that require substantial support. Addressing these issues through lifestyle adjustments is crucial. Rather than attempting to tackle every aspect of diabetes management simultaneously, focusing on small, manageable goals can be more effective. One vital area to start with is the incorporation of meditation and mindfulness practices, supported by motivational guidance, to enhance overall patient well-being.

The Interplay between Mental Health and Diabetes Management

Mental health significantly influences various aspects of daily life, impacting how individuals think, feel, manage stress, interact with others, and make decisions. Consequently, mental health issues can complicate adherence to a diabetes care plan.1

Thoughts, feelings, beliefs, and attitudes play a crucial role in overall health. Untreated mental health problems can exacerbate diabetes, and conversely, diabetes complications can worsen mental health issues. Fortunately, improvement in one area often leads to improvement in the other.1

Diabetes can have a serious psychological and emotional impact, affecting both self-management and quality of life. People with diabetes are two to three times more likely to experience depression compared to those without diabetes. However, only 25% to 50% of individuals with diabetes and depression receive a diagnosis and treatment.1

A range of psychological problems can occur in individuals with diabetes, including depression, anxiety, and diabetes-related distress.2 Anxiety, characterized by feelings of worry, fear, or unease, is the body’s response to stress. People with diabetes are 20% more likely to experience anxiety than those without the condition.1 When anxiety is present, A1c levels can be significantly higher, and panic attacks can make diabetes management challenging, even during minor episodes.3

Managing stress and coping with the emotional aspects of diabetes are crucial. Managing stressors effectively can help reduce blood sugar levels, as glucose is released by the adrenal glands when stressed. Stress and anxiety can easily escalate into difficult emotions, creating a vicious cycle. Learning to cope with the pressures of type 2 diabetes self-care highlights the essential need for a support system, which may include a meditation coach. Gaining control and confidence through better emotional and physical health is possible with the right support and coping strategies.3

Depression symptoms can range from mild to severe and may include:

  • Feeling sad or empty
  • Losing interest in favorite activities
  • Overeating or having no appetite
  • Insomnia or excessive sleeping
  • Difficulty concentrating or making decisions
  • Extreme fatigue
  • Feelings of hopelessness, irritability, anxiety, or guilt
  • Physical symptoms such as aches, pains, headaches, cramps, or digestive issues
  • Thoughts of suicide or death1

Feelings of discouragement, worry, frustration, or fatigue from daily diabetes management may arise, especially when efforts do not yield desired results. These overwhelming feelings, known as diabetes distress, can lead individuals to neglect their self-care, revert to unhealthy habits, stop monitoring their blood sugar, or miss their doctor’s appointments. This phenomenon affects many, if not most, people with diabetes, often after years of diligent management. In any given 18-month period, 33% to 55% of individuals with diabetes experience diabetes distress.1

Coping skills to decrease anxiety and panic attacks include techniques such as deep breathing4, meditation5, and mindfulness6. These practices, along with talking with someone a patient trusts, can help reduce feelings of stress, depression, or anxiety. They can also address problems with sleep, memory, and how diabetes affects various aspects of life, including family, work, and financial situations.7
Identifying Emotional Symptoms in Diabetes Patients
To identify symptoms of depression or anxiety in diabetes patients, the physician would ask these two key questions:

  1. “During the last month, have you often been bothered by feeling down, depressed, or hopeless?”
  2. “During the last month, have you often been bothered by having little interest or pleasure in doing things?”8

If the patient answers ‘yes’ to either question, further assessment is necessary. Additional questions to evaluate depression could include:

  • “During the last month, have you often been bothered by feelings of worthlessness?”
  • “During the last month, have you often been bothered by poor concentration?”
  • “During the last month, have you often been bothered by thoughts about death?”9

Besides an interview, a useful tool for assessing distress, for instance, is the Distress Thermometer. This self-report measure consists of a scale from 0 to 10, with 0 indicating “No distress” and 10 indicating “Extreme distress.” Patients are asked, “How distressed have you been during the past week on a scale of 0-10?” A score of 4 or above indicates the need for intervention. The Distress Thermometer is recommended by best international practices and has proven effective in managing services for patients with diabetes.2

The Distress Thermometer also includes a problem checklist where patients can identify specific issues contributing to their distress.12/2 This could include individual emotions common among diabetics, rated on a 0-10 scale. The assessment also allows patients to add personal concerns.

All information is then reviewed by the presiding physician to determine appropriate interventions. Some cases may require therapies beyond meditation, particularly when mental conditions are at extreme stages. Meanwhile, the meditation coach reviews the results for patients recommended by the doctor for meditation and provides the prescribed care.

The Meditation Coach’s Approach to Motivational Support

The meditation coach plays a crucial role in providing motivational support to diabetes patients, utilizing strategies that foster positive behavior change. Research indicates that patients often have negative perceptions of standard care, describing it as paternalistic and demeaning. In contrast, a meditation coach’s approach is more patient-centered and empowering, emphasizing motivational interviewing techniques.10

A qualitative study aimed to understand patient experiences with motivational interviewing interventions revealed five key themes: nonjudgmental accountability, being heard and responded to as a person, encouragement and empowerment, collaborative action planning and goal setting, and coaching rather than critiquing. These themes underscore the importance of a supportive, empathetic approach that contrasts sharply with traditional care models.10

Motivational interviewing involves the patient doing most of the talking, discussing specific behavioral targets while the practitioner focuses on problem recognition and resolving ambivalence about change. This patient-centered approach helps patients work through their ambivalence, enhancing their readiness for change.11

The Patient Empowerment Model, widely recognized in diabetes care, emphasizes helping patients assess what is important or possible for them and how to achieve change. Motivational interviewing, rooted in Rogerian psychotherapy, includes three key aspects: collaborating with and empowering the patient, respecting and supporting patient autonomy and problem-solving capabilities, and developing motivation through patient goals and shifting ambivalence to confidence.11

As a meditation coach, empathy and flexibility are essential in building relationships with patients. Reflective listening, which involves accurately understanding a patient’s story through open questions, reflections, gentle probing for more details, and use of summaries, is critical for comprehending patients’ personal connections to targeted health behaviors and developing warm rapport.11 This “bottom-up” approach creates rapport, motivates patients, and meets their unique needs through meditation and coaching.

Empathetic communication that empowers and respects patients includes asking for permission to propose plans or share information. Flexibility involves allowing patients to explain their current behavior, personal goals, interests, and values. Self-efficacy is improved by providing choices, such as whether they want to engage in meditation and which meditation techniques they prefer.11

To enhance and maintain motivation, the meditation coach provides practical tips, including:

  • Be an active participant in your own health care.
  • Use stress management techniques.
  • Learn to live in the present.
  • Grieve your losses and feel your feelings.
  • Develop the spiritual side of yourself, in accordance with your beliefs.
  • Make realistic goals and approach them in manageable increments.12

By adopting these strategies, the meditation coach can effectively support diabetes patients by motivating them to meditate and practice mindfulness, managing their condition, and improving their overall well-being.

Meditation and Mindfulness for Diabetes Management

Low-intensity mindfulness meditations, approximately 10 minutes in length, are recommended for diabetes patients. These practices differ from traditional meditation techniques, which can be psychologically challenging. Mindfulness meditations involve maintaining awareness of the present moment without judgment or interpretation. Techniques may include observing one’s breath or physical sensations, guided imagery, or repeating a specific syllabic sound, all aimed at obtaining physical and psychosocial benefits.

To be clear, individuals with mild to moderate difficulties coping with diabetes and its perceived consequences are suitable candidates for meditation. This includes those experiencing low to moderate levels of stress, mood swings, depression, and anxiety. However, individuals with severe depression, complex mental illnesses, or those on medications for psychological disorders should consult a psychologist or psychiatrist for appropriate treatment rather than practicing meditation, as previously addressed in the section “Identifying Emotional Symptoms in Diabetes Patients”.

Meditation and guided imagery, such as visualizing positive images to relax the mind, can help control blood sugar levels. Research indicates that “those who participated in any of the mind-body activities for any length of time lowered their levels of hemoglobin A1C, a key marker for diabetes. On average, A1C dropped by 0.84%.”6 Dr. Shalu Ramchandani at the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital states, “A relaxation response can lower levels of stress hormone cortisol. This improves insulin resistance and keeps blood sugar levels in check, thus lowering A1C levels.”6 Relaxation also improves blood flow, lowers blood pressure, and protects against heart attacks and strokes. Given these benefits, researchers consider mindfulness practices an integral part of diabetes therapy.6

Practicing mindfulness for at least 10 minutes a day helps improve concentration and memory skills. The goal is to achieve relaxation by intentionally paying attention to sensations and thoughts without judgment, enabling the mind to focus better on the present moment and achieve acceptance.13

“The practice of meditation is associated with greater voluntary control of the mind and emotions and cultivation of positive mental attributes such as calmness, serenity, concentration, joy and love, and reduction of negative emotions such as anxiety, depression, anger, fear, or hatred.” (Walsh et al., 2006, cited in Priya et al., 2018)

“Thus, it can reduce reaction to stress and improve coping skills, attention, awareness, memory, sensory perception and cognitive regulation of emotions and help develop a more coherent sense of self and identity.” (Acevedo et al., 2016, cited in Priya et al., 2018)

Conclusion

Meditation and mindfulness interventions with motivational support offer significant benefits for the physiological, psychological, and social aspects of diabetes management. By integrating these practices, patients can experience reduced stress, improved blood sugar control, and enhanced emotional resilience. These holistic approaches not only aid in managing diabetes more effectively, but also contribute to a better quality of life. Empowering patients with these tools fosters a proactive attitude towards their health, ultimately leading to sustained well-being and improved health outcomes.

References

  1. Diabetes and mental health. (2024, May 15). Diabetes. https://www.cdc.gov/diabetes/living-with/mental-health.html?CDC_AAref_Val=https://www.cdc.gov/diabetes/m
  2. O’Donnell, E., D’Alton, P., O’Malley, C., Gill, F., & Canny, A. (2013). The Distress Thermometer: a rapid and effective tool for the oncology social worker. International Journal of Health Care Quality Assurance, 26(4), 353-359. https://doi.org/10.1108/09526861311319573
  3. Montgomery, B. (2018, September 15). Dealing with Emotions: How Diabetes Can Affect Your Mood. TheDiabetesCouncil.com. https://www.thediabetescouncil.com/role-of-emotion-in-dealing-with-diabetes-strong-will-is-important/
  4. DiLonardo, M. J. (2023, May 21). 6 lifestyle changes to control your diabetes. WebMD. https://www.webmd.com/diabetes/diabetes-lifestyle-tips
  5. Living with Diabetes. (2024, May 15). Diabetes. https://www.cdc.gov/diabetes/living-with/index.html
  6. Solan, M. (2023, February 6). A mindful way to help manage type 2 diabetes? Harvard Health. https://www.health.harvard.edu/blog/a-mindful-way-to-help-manage-type-2-daibetes-202302062885
  7. Healthy Living with Diabetes. (2024, June 5). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/healthy-living-with-diabetes#mentalhealth
  8. Diabetes Research & Wellness Foundation. (n.d.). The psychological impact of diabetes – Diabetes Research & Wellness Foundation. Diabetes Research & Amp; Wellness Foundation. https://www.drwf.org.uk/news-and-events/news/the-psychological-impact-of-diabetes/
  9. NICE. (2009, October 28). Recommendations | Depression in adults with a chronic physical health problem: recognition and management | Guidance | NICE. https://www.nice.org.uk/guidance/cg91/chapter/Recommendations#stepped-care
  10. Dellasega, C., Ańel-Tiangco, R. M., & Gabbay, R. A. (2012). How patients with type 2 diabetes mellitus respond to motivational interviewing. Diabetes Res Clin Pract., 95(1): 37-41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686502/
  11. Welch, G., Rose, G., & Ernst, D. (2006). Motivational interviewing and diabetes: what is it, how is it used, and does it work? Diabetes Spectrum, 19(1), 5-11. https://doi.org/10.2337/diaspect.19.1.5
  12. Diabetesnet.com – The Diabetes Mall. (2019, October 7). Staying Motivated with Diabetes. Diabetesnet.com. https://www.diabetesnet.com/about-diabetes/newly-diagnosed/motivation/
  13. Solan, M. (2021, October 14). Evoking calm: Practicing mindfulness in daily life helps. Harvard Health. https://www.health.harvard.edu/blog/evoking-calm-practicing-mindfulness-in-daily-life-helps-202110142617
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