Mindfulness: a Novel Approach for the Management of Diabetes-related Distress

Inclusion criteria

• Age > 30 years
• Male or female
• Duration of diabetes 1-15 years from time of initial diagnosis
• Diagnosis of T2DM made/confirmed by physician
• Completed diabetes education in the past
• Most recent HgA1c >7%; measurement must be within the past 6 months either in physicians office or at the Thriving with Diabetes Boot Camp Class
• Treatment for diabetes must include any or all of the following modalities:

diet, exercise, oral medications, insulin or other injectable diabetic medication

• Score > 30 on the Problem Area in Diabetes (PAID) Questionnaire
• Able to use a glucometer for self-monitoring of blood glucose values
• Most recent clinic blood pressure less than 180/95

Exclusion criteria

• History of ketoacidosis
• Age at diagnosis of T2DM < 30 years
• Score >15 on the PHQ-9
• Previous training in relaxation or meditation techniques
• Current practice of yoga, tai chi or any other mind-body movement for > 60 minutes per week
• Current use of a psychoactive drug for less than 3 months or not yet on a stable dose
• Inability to participate fully or behave appropriately in the group treatment setting, as observed by baseline acknowledgement of substance abuse, psychotic episode(s), psychiatric hospitalization or history of self- harm within the past 2 years, or current suicidal or homicidal ideation
• Inability to complete standardized instruments because of a cognitive deficit or language barrier
• Current use or use within the past 3 months of oral glucocorticoids, excluding intraocular, topical or inhaled preparations
• History of inflammatory diseases including rheumatoid arthritis and inflammatory bowel disease
• Use of immune modulating agents
• Night shift work or other type of schedule in which sleep wake cycle is disrupted
• Women who consume > 7 alcoholic drinks per week and men who consume > 14 drinks per week
• Current use or history of daily tobacco use within the past 1 year
• End stage renal failure on dialysis
• Pregnancy or post partum <3 months
• Subjects with known secondary causes of hypertension including renal artery stenosis, pheochromocytoma, coarctation of aorta, hyperaldosteronemia
• Non-dominant arm circumference > 46cm
• Unwilling to accept randomization