Table 1 Summary of enrolled studies
Subjects (CBT vs usual treatment) | CBT content vs usual treatment | Blinded | Outcome of interest | |
|---|---|---|---|---|
Alshehri 2020 (USA) [32] | Type 2 DM 14 (40–75 years old) vs 14 (40–75 years old) | CBT for insomnia vs Health education Duration: 50 days | Unblinded | glycemic control,diabetes self-care behavior, and fatigue |
Amsberg 2009 (Sweden) [22] | Type 1 DM 40 (22 M, 18 F, 41.1 ± 11.7 years old) vs 39 (16 M, 23 F, 41.4 ± 12.9 years old) | CBT-based Intervention Vs Usual treatment (including Continuous monitoring of blood glucose level) Duration: 48 weeks | Unblinded | HbA1c, self-care behaviors and psychosocial factors |
Cummings 2019 (USA) [31] | Type 2 DM 67 (14 M, 53 F, 51 ± 9 years old) vs 72 (17 M, 55 F, 53 ± 9 years old) | A tailored CBT intervention plus lifestyle counseling and standard medical care vs usual treatment Duration: 12 months | Unblinded | HbA1c, regimen-related distress, depression, self-care behaviors, medication adherence, systolic blood pressure, body weight |
Fisher 2018 (USA) [28] | Type 1 DM 149 (44 M, 105 F, 47.3 ± 14.5 years old) vs 152 (49 M, 103 F, 42.8 ± 15.1 years old) | OnTrack used a variety of scenarios and exercises, based on emotion regulation, that focused on ways to deal with the emotional side of diabetes and how to develop personalized emotion management techniques vs Know It included a diabetes update of key factors regarding the causes and management of T1D, based on a UCSF Diabetes Education Program. Duration: 3 months and 9 months | Unblinded | Diabetes distress, powerlessness, diabetes management, hypoglycemic distress, negative social perceptions, eating distress, physical distress, friend and family distress, HbA1c |
Henry 1997 (Australia) [18] | type 2 DM 10 (4 M, 6 F) vs 9 (5 M, 4 F) 59.8 years old (47–74 years old) | CBT (6 weekly 1.5-h sessions conducted in 2 small groups) vs waiting list Duration: 6 weeks | Unblinded | HbA1c, Blood glucose, State anxiety, Hassless frequency, perceived stress, coping ability, Beck Depression Inventory |
Lustman 1998 (USA) [19] | Type 2 DM with major depression 20 (8 M, 12 F, 53.1 ± 10.5 years old) vs 22 (9 M, 13 F, 56.4 ± 9.7 years old) | Individual CBT (1 h weekly for 10 weeks) vs diabetes education Duration: 10 weeks | Unblinded | Depression severity, Depression remission, HbA1c |
Menting 2017 (Netherlands) [25] | Type 1 DM 60 (23 M, 37 F, 44.4 ± 12.1 years old) vs 60 (23 M, 37 F, 42.9 ± 12.5 years old) | The CBT intervention (Dia-Fit) was given for 5 months in blended form, consisting of face-to-face and web-based sessions vs waiting list Duration: 5 months | Unblinded | Fatigue severity, Functional impairment, HbA1c, glucose variability |
Newby 2017 (Australia) [26] | Type 1&2 DM 41 (8 M, 33 F, 43.5 ± 13.3 years old) vs 49 (18 M, 31 F, 49.3 ± 11.5 years old) | Internet-based CBT (participants completed 6 automated cartoon-style web-based lessons teaching CBT skills over 10 weeks, with a minimum wait-time of 5 days between lesson) vs usual treatment Duration: 3 months | Unblinded | HbA1c, problem areas in diabetes scale, Kessler 10-item psychological distress scale, short form 12-item mental health subscale, short form 12-item physical health subscale, generalized anxiety disorder 7-item scale, patient health questionnaire 15-item somatization scale |
Safren 2014 (USA) [24] | Type 2 DM 45 (22 M, 23 F, 55.44 ± 8.72 years old) vs 42 (22 M, 20 F, 58.31 ± 7.41 years old) | CBT vs usual treatment Duration: 4 months | Single blinded | HbA1c the effectiveness of CBT for medicine adherence and depression in patients |
Schmitt 2022 (Germany) [36] | Type 1&2 DM 131 (56 M, 75 F, 45.2 ± 13.9 years old) vs 129 (62 M, 67 F, 44.9 ± 15.1 years old) | Stepped CBT (step 1: Five sessions (90 min each) of diabetes-specific CBT group step 2: 6 to 12 sessions of single CBT for depression (50 min each) via telephone step 3: Referral for outpatient depression treatment by psychotherapist and/or psychiatrist vs usual treatment Duration: 6 months and 12 months | Unblinded | HbA1c, rate of meaningful depression reduction, problem areas in diabetes scale, Kessler 10-item psychological distress scale, short form 12-item mental health subscale, short form 12-item physical health subscale, generalized anxiety disorder 7-item scale, patient health questionnaire 15-item somatization scale, interleukin-6,18,1 receptor anatagonist |
Snoek 2008 (Netherlands) [21] | Type 1 DM 45 (18 M, 27 F, 38.1 ± 9.7 years old) vs 41 (14 M, 27 F, 37.4 ± 11.1 years old) | group CBT vs usual treatment Duration: 12 months | Unblinded | HbA1c, Depression scales |
Stanger 2018 (USA) [29] | Type 1 DM 30 (19 M, 11 F, 15.2 ± 1.4 years old) vs 31 (16 M, 15 F, 14.9 ± 1.5 years old) | Web delivered CBT (incentives, brief motivational interviewing/CBT and parent contingency contracting sessions, and working memory training all delivered over the internet) vs usual treatment Duration: 6 months and 12 months | Unblinded | HbA1c, self-monitoring of blood glucose Parent monitoring, visual spatial working memory scale, Diabetes Family Conflict Scale, Stroop color-word interference |
van der Ven 2005 (Netherlands) [20] | Type 1 DM 52 vs 55 | Group CBT vs usual treatment | Unblinded | HbA1c, confidence in diabetes self-care scale, problem areas in diabetes questionnaire, center for epidemiological studies depression scale |
Wei 2018 (UK) [30] | Type 1 DM 43 (19 M, 24 F, mean 13.2 years old) vs 42 (19 M, 23 F, mean 14.1 years old) | CBT (six 1-to-1 weekly sessions with single follow-up sessions at 6 and 12 months) vs usual treatment Duration: 3, 9, 12, 24 months | Unblinded | HbA1c, diabetes family behaviour scale, diabetes’ quality of life for youths, locus of control,well-being questionnaire |
Welschen 2013 (Netherlands) [23] | Type 2 DM 76 (45 M, 31 F, 60.5 ± 9.4 years old) vs 78 (50 M, 28 F, 61.2 ± 8.8 years old) | CBT vs Usual treatment Duration: 6 months | Unblinded | The effects of CBT for reducing the risk of CHD, HbA1c, total cholesterol blood pressure, depression scale |
Whitehead 2017 (Australia) [27] | Type 2 DM 39 (17 M, 22 F, 56.1 ± 6.9 years old) vs 45 (50 M, 28 F, 61.2 ± 8.8 years old) | CBT-based acceptance and commitment therapy vs usual treatment Duration: 3 and 6 months | Double blinded | HbA1c, anxiety scale, depression scale diabetes treatment satisfaction questionnaire |
Xu 2021 (China) [34] | Type 2 DM 597 (186 M, 411 F, 63.81 ± 9.94 years old) vs 611 (218 M, 393 F, 62.91 ± 9.59 years old) | Group CBT (10 sessions in 10 consecutive days. Each session lasted 40–50 min and was followed by a 10- to 15-min discussion) vs usual treatment Duration: 2, 6 and 12 months | Unblinded | HbA1c, generalized anxiety disorder 7-item scale, patient health questionnaire |
Zhang 2021 (China) [35] | Type 2 DM 568 (198 M, 370 F, 61.58 ± 9.17 years old) vs 574 (191 M, 383 F, 61.83 ± 8.64 years old) | CBT vs Usual treatment Duration: 2, 6 and 12 months | Unblended | HbA1c, Pittsburgh sleep quality index |
Zuo 2020 [33] | Type 2 DM 94 (32 M, 62 F, 63.9 ± 10.2 years old) vs 93 (29 M, 64 F, 61.7 ± 10.4 years old) | CBT (a 2-month involving seven sessions. Each session lasted 40–50 min, and was followed by a 10–15-min discussion) vs usual treatment Duration: 2 and 6 months | Double blinded | HbA1c, Pittsburgh sleep quality index, diabetes-specific quality of life scale |