Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osakasayama, Japan.
Department of Internal Medicine, Itami Seifu Houpital, Itami, Japan.
J Diabetes Investig. 2022 Feb;13(2):262-270. doi: 10.1111/jdi.13658. Epub 2021 Sep 27.
AIMS/INTRODUCTION: This systematic review and meta-analysis aimed to investigate the efficacy and safety of acceptance and commitment therapy (ACT) for people with type 2 diabetes mellitus.
Several electronic databases were examined on 16 January 2021, including PubMed, CENTRAL, PsycINFO, International Clinical Trials Registry Platform and ClinicalTrials.gov. Randomized controlled trials were included to compare ACT with usual treatment for people with type 2 diabetes reported in any language. Primary outcome measures were glycated hemoglobin, self-care ability assessed by the summary of diabetes self-care activities and all adverse events. The secondary outcome measure was acceptance assessed by the acceptance and action diabetes questionnaire.
Of 678 publications initially identified, three trials were included in the meta-analysis. ACT resulted in a reduction in glycated hemoglobin (mean difference -0.62 points lower in the intervention group; 95% confidence interval -1.07 to -0.16; I = 0%; low-quality evidence). In addition, ACT increased the score of the summary of diabetes self-care activities (mean difference 8.48 points higher in the intervention group; 95% confidence interval 2.16-14.80; high-quality evidence). Adverse events were not measured in all trials. ACT increased scores of the acceptance and action diabetes questionnaire (mean difference 5.98 points higher in the intervention group; 95% confidence interval, 1.42-10.54; I = 43%; low-quality evidence).
ACT might reduce glycated hemoglobin, and increase self-care ability and acceptance among people with type 2 diabetes.
目的/引言:本系统评价和荟萃分析旨在研究接受和承诺疗法(ACT)对 2 型糖尿病患者的疗效和安全性。
我们于 2021 年 1 月 16 日检索了多个电子数据库,包括 PubMed、CENTRAL、PsycINFO、国际临床试验注册平台和 ClinicalTrials.gov,纳入了用任何语言报告的比较 2 型糖尿病患者接受 ACT 与常规治疗的随机对照试验。主要结局指标为糖化血红蛋白、通过糖尿病自我护理活动综合评估的自我护理能力以及所有不良事件。次要结局指标为通过接受与行动糖尿病问卷评估的接受程度。
最初确定的 678 篇文献中,有 3 项试验纳入荟萃分析。ACT 可降低糖化血红蛋白(干预组低 0.62 个百分点;95%置信区间为-1.07 至-0.16;I²=0%;低质量证据)。此外,ACT 可提高糖尿病自我护理活动综合评估的评分(干预组高 8.48 分;95%置信区间为 2.16-14.80;高质量证据)。并非所有试验都测量了不良事件。ACT 可提高接受与行动糖尿病问卷的评分(干预组高 5.98 分;95%置信区间为 1.42-10.54;I²=43%;低质量证据)。
ACT 可能降低 2 型糖尿病患者的糖化血红蛋白,提高自我护理能力和接受程度。