Relationships between dispositional mindfulness, health behaviors, and hemoglobin A1c among adults with type 2 diabetes

J Fanning, C Y Osborn, A E Lagotte, L S Mayberry, J Fanning, C Y Osborn, A E Lagotte, L S Mayberry

Abstract

Examine cross-sectional relationships between dispositional mindfulness and diabetes self-care behaviors (i.e., medication adherence, diet and exercise behavior, and self-monitoring of blood glucose; SMBG), hemoglobin A1c (HbA1c, %), and body mass index (BMI; continuously and obese vs. not). Adults with type 2 diabetes (N = 148, Mage = 55.7 ± 10.1) who were recruited to participate in a web-based diabetes medication adherence intervention completed all assessments at enrollment. In unadjusted analyses, mindfulness was associated with better dietary habits and worse HbA1c (p < .05). After controlling for a priori covariates (demographics, years since diabetes diagnosis, and insulin status), mindfulness remained associated with better dietary behavior (p < .01) but not HbA1c. Mindfulness was not associated with medication adherence, exercise behavior, SMBG, or body mass index. We found evidence that dispositional mindfulness plays an important role in dietary behaviors, supporting the use of mindful eating techniques in diabetes self-management interventions. Fostering mindfulness may be one of several behavioral tools needed to support key self-care behaviors and improve HbA1c.

Keywords: Diabetes mellitus; Diet; Exercise; Health behavior; Mindfulness; Self-care.

References

    1. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13(1):27–45. doi: 10.1177/1073191105283504.
    1. Bekker MHJ, van de Meerendonk C, Mollerus J. Effects of negative mood induction and impulsivity on self-perceived emotional eating. International Journal of Eating Disorders. 2004;36(4):461–469. doi: 10.1002/eat.20041.
    1. Birnie K, Speca M, Carlson LE. Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR) Stress and Health. 2010;26(5):359–371. doi: 10.1002/smi.1305.
    1. Brown KW, Ryan RM. The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology. 2003;84(4):822–848. doi: 10.1037/0022-3514.84.4.822.
    1. Caluyong MB, Zambrana AF, Romanow HC, Nathan HJ, Nahas R, Poulin PA. The relationship between mindfulness, depression, diabetes self-care, and health-related quality of life in patients with Type 2 Diabetes. Mindfulness. 2015;6(6):1313–1321. doi: 10.1007/s12671-015-0401-z.
    1. Carmody J, Reed G, Kristeller J, Merriam P. Mindfulness, spirituality, and health-related symptoms. Journal of Psychosomatic Research. 2008;64(4):393–403. doi: 10.1016/j.jpsychores.2007.06.015.
    1. Centers for Disease Control and Prevention. [Accessed 11 May 2017];2014 National Diabetes Statistics Report. 2014 .
    1. Chaput JP. Short sleep duration promoting overconsumption of food: a reward-driven eating behavior? Sleep. 2010;33(9)
    1. Dalen J, Smith BW, Shelley BM, Sloan AL, Leahigh L, Begay D. Pilot study: Mindful Eating and Living (MEAL): weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. Complementary Therapies in Medicine. 2010;18 doi: 10.1016/j.ctim.2010.09.008.
    1. Duncan LG, Moskowitz JT, Neilands TB, Dilworth SE, Hecht FM, Johnson MO. Mindfulness-based stress reduction for HIV treatment side effects: a randomized, wait-list controlled trial. Journal of Pain and Symptom Management. 2012;43(2):161–71. doi: 10.1016/j.jpainsymman.2011.04.007.
    1. Fisher L, Hessler DM, Polonsky WH, Mullan J. When is diabetes distress clinically meaningful? Establishing cut points for the Diabetes Distress Scale. Diabetes care. 2012;35(2):259–64. doi: 10.2337/dc11-1572.
    1. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and Science in Sports and Exercise. 2011;43(7):1334–59. doi: 10.1249/MSS.0b013e318213fefb.
    1. Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. Journal of Consulting and Clinical Psychology. 2007;75(2):336–343. doi: 10.1037/0022-006X.75.2.336.
    1. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics. 2009;42(2):377–381. doi: 10.1016/j.jbi.2008.08.010.
    1. Hartmann M, Kopf S, Kircher C, Faude-Lang V, Djuric Z, Augstein F, et al. Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients: design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-Study) Diabetes Care. 2012;35(5):945–947. doi: 10.2337/dc11-1343.
    1. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology. 2010;78(2):169–183. doi: 10.1037/a0018555.
    1. Jordan CH, Wang W, Donatoni L, Meier BP. Mindful eating: trait and state mindfulness predict healthier eating behavior. Personality and Individual Differences. 2014;68:107–111. doi: 10.1016/j.paid.2014.04.013.
    1. Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, N.Y: Dell Pub; 1991.
    1. Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review. 2011;31(6):1041–1056. doi: 10.1016/j.cpr.2011.04.006.
    1. Kiken LG, Garland EL, Bluth K, Palsson OS, Gaylord SA. From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Personality and Individual Differences. 2015;81:41–46. doi: 10.1016/j.paid.2014.12.044.
    1. Kong F, Wang X, Zhao J. Dispositional mindfulness and life satisfaction: the role of core self-evaluations. Personality and Individual Differences. 2014;56:165–169. doi: 10.1016/j.paid.2013.09.002.
    1. Kripalani S, Risser J, Gatti ME, Jacobson TA. Development and evaluation of the adherence to refills and medications scale (arms) among low-literacy patients with chronic disease. Value in Health. 2009;12(1):118–123. doi: 10.1111/j.1524-4733.2008.00400.x.
    1. Levesque C, Brown KW. Mindfulness as a moderator of the effect of implicit motivational self-concept on day-to-day behavioral motivation. Motivation and Emotion. 2007;31(4):284–299. doi: 10.1007/s11031-007-9075-8.
    1. Loucks EB, Gilman SE, Britton WB, Gutman R, Eaton CB, Buka SL. Associations of mindfulness with glucose regulation and diabetes. American Journal of Health Behavior. 2016;40(2):258–67. doi: 10.5993/AJHB.40.2.11.
    1. Mayberry LS, Gonzalez JS, Wallston KA, Kripalani S, Osborn CY. The ARMS-D out performs the SDSCA, but both are reliable, valid, and predict glycemic control. Diabetes Research and Clinical Practice. 2013;102(2):96–104. doi: 10.1016/j.diabres.2013.09.010.
    1. Miller CK, Kristeller JL, Headings A, Nagaraja H, Miser WF. Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a pilot study. Journal of the Academy of Nutrition and Dietetics. 2012;112(11):1835–1842. doi: 10.1016/j.jand.2012.07.036.
    1. Nelson LA, Bethune MC, Lagotte AE, Osborn CY. The usability of diabetes map: a web-delivered intervention for improving medication adherence. JMIR Human Factors. 2016;3(1):e13. doi: 10.2196/humanfactors.5177.
    1. Noordali F, Cumming J, Thompson JL. Effectiveness of mindfulness-based interventions on physiological and psychological complications in adults with diabetes: A systematic review. Journal of Health Psychology. 2017;22(8):965–983. doi: 10.1177/1359105315620293.
    1. Park T, Reilly-Spong M, Gross CR. Mindfulness: a systematic review of instruments to measure an emergent patient-reported outcome (PRO) Quality of Life Research. 2013;22(10):2639–59. doi: 10.1007/s11136-013-0395-8.
    1. Polonsky WH. Poor medication adherence in diabetes: What’s the problem? Journal of Diabetes. 2015;7:777–778. doi: 10.1111/dme.12651.2.
    1. Ryan RM, Deci EL. Self-regulation and the problem of human autonomy: does psychology need choice, self-determination, and will? Journal of Personality. 2006;74(6):1557–1586. doi: 10.1111/j.1467-6494.2006.00420.x.
    1. Salmoirago-Blotcher E, Carey MP. Can mindfulness training improve medication adherence? Integrative review of the current evidence and proposed conceptual model. Explore. 2018;14(1):59–65. doi: 10.1016/J.EXPLORE.2017.09.010.
    1. Shahar B, Britton WB, Sbarra DA, Figueredo AJ, Bootzin RR. Mechanisms of change in mindfulness-based cognitive therapy for depression: Preliminary evidence from a randomized controlled trial. International Journal of Cognitive Therapy. 2010;3(4):402–418. doi: 10.1521/ijct.2010.3.4.402.
    1. Shapiro SL, Oman D, Thoresen CE, Plante TG, Flinders T. Cultivating mindfulness: Effects on well-being. Journal of Clinical Psychology. 2008;64(7):840–862. doi: 10.1002/jclp.20491.
    1. Stirratt MJ, Dunbar-Jacob J, Crane HM, Simoni JM, Czajkowski S, Hilliard ME, et al. Self-report measures of medication adherence behavior: recommendations on optimal use. Translational Behavioral Medicine. 2015;5(4):470–82. doi: 10.1007/s13142-015-0315-2.
    1. Thompson BL, Waltz JA. Mindfulness, self-esteem, and unconditional self-acceptance. Journal of Rational-Emotive & Cognitive-Behavior Therapy. 2008;26(2):119–126. doi: 10.1007/s10942-007-0059-0.
    1. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care. Diabetes Care Journal. 2000;23(7):943–950. doi: 10.2337/diacare.23.7.943.
    1. Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007;23(11):887–894. doi: 10.1016/j.nut.2007.08.008.
    1. van Son J, Nyklicek I, Pop VJ, Blonk MC, Erdtsieck RJ, Spooren PF, et al. The effects of a mindfulness-based intervention on emotional distress, quality of life, and HbA1c in outpatients with diabetes (DiaMind): A randomized controlled trial. Diabetes Care. 2013;36(4):823–830. doi: 10.2337/dc12-1477.
    1. Young L, Cappola A, Baime M. Mindfulness Based Stress Reduction: effect on emotional distress in diabetes. Practical Diabetes International. 2009;26(6):222–224. doi: 10.1002/pdi.1380.

Source: PubMed

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