One-Year Follow-Up of a Randomized Controlled Trial Piloting a Mindfulness-Based Group Intervention for Adolescent Insulin Resistance

Abstract

Introduction: To explore if a brief mindfulness-based intervention (MBI) leads to sustained, improved clinical outcomes in adolescents at-risk for type 2 diabetes (T2D).

Methods: Participants were 12-17y girls with overweight/obesity, elevated depression symptoms, and T2D family history participating in a randomized, controlled pilot trial of a six-session MBI vs. cognitive-behavioral therapy (CBT) group. At baseline and 1-year, mindfulness, depression, insulin resistance (IR), and body composition were assessed with validated instruments.

Results: One-year retention was 71% (n = 12) in MBI; 81% (n = 13) in CBT. At 1-year, depression decreased (Cohen's d = 0.68) and IR decreased (d = 0.73) in adolescents randomized to MBI compared to those in CBT. There were no significant between-condition differences in mindfulness, adiposity, or BMI.

Discussion: One-year outcomes from this randomized, controlled pilot trial suggest that brief MBI may reduce depression and IR in at-risk adolescents. Replication and exploration of mechanisms within the context of a larger clinical trial are necessary.

Clinical trial registration: www.ClinicalTrials.gov, identifier NCT02218138.

Keywords: adolescents; cognitive-behavioral therapy; depression; insulin resistance; mindfulness; type 2 diabetes.

Figures

FIGURE 1

Baseline to 1-year change (Mean, SE) in (A) depression symptoms, (B) homeostasis model assessment of insulin resistance (HOMA-IR), (C) dispositional mindfulness, (D) adiposity (%), (E) body mass index (BMI; k/gm2), and (F) BMI z-score by condition: MBI (mindfulness-based group intervention; n = 17) vs. CBT (cognitive-behavioral therapy; n = 16) group intervention. P-values refer to the between-group difference in baseline to 1-year change, derived from univariate analyses of covariance (ANCOVA) using the intent-to-treat sample with EM (expectation–maximation) to handle missing data. Models a, b, and c accounted for race/ethnicity, baseline level of the outcome, baseline age, baseline weight status (overweight BMI 85th–94th percentile vs. obesity BMI ≥ 95th percentile), baseline puberty (Tanner 5 reported breast development vs. Tanner 3–4), baseline adiposity, and 1-year change in adiposity. Models d and e accounted for race/ethnicity, baseline level of the outcome, baseline age, baseline weight status, and baseline puberty.