In Brief

Acknowledging negative thought about their disease may help people with diabetes keep glucose levels stable, says a study in the April Journal of Consulting & Clinical Psychology (Vol. 75, No. 2). That's because attempts to avoid these thoughts often bring on more stress, says the study's lead author, Jennifer Gregg, PhD, assistant psychology professor at San Jose State University.

Just looking at a sugary snack causes some patients to worry about the life-threatening aspects of diabetes, says Gregg. She found that teaching patients to acknowledge thoughts and feelings related to diabetes using an approach known as Acceptance and Commitment Therapy (ACT) helped them better care for themselves.

In the study, 81 patients with Type II diabetes attended a one-day education workshop at a clinic near San Francisco. Thirty-eight participants randomly assigned to the education-only session received information on diabetes management, including diet, exercise and how to test their blood glucose. The rest of the patients received a condensed version of this education, and then learned ACT's acceptance-based coping techniques.

In one ACT exercise, for example, the instructor asked patients to envision their funeral eulogy and what patients would want said about how they took care of their disease. For many patients, says Gregg, this helped them connect their goals and values to the disease, diminishing the power of their fears. One common goal voiced by participants was to properly manage their diabetes so they could be around for family, friends and other things that were important to them, such as living to see their grandchildren get married.

Three months after the workshop, the number of people with blood sugar levels in the acceptable range jumped 23 percent for the group receiving ACT training. Conversely, the number of participants in diabetic control in the education-only group dropped 2 percent. Results also showed significant improvements in the ACT participants' self-management of the disease, based on self-reported scores on exercise, diet and glucose monitoring.

The study offers people with diabetes hope for improved disease management by suggesting that ACT training may help them cope more effectively with the psychological challenges of this chronic and life-threatening disease.

"When you start talking to people with diabetes about what they need to do to take care of themselves, pretty quickly they start feeling overwhelmed by it," says Gregg. "More standard forms of education don't really make room for those feelings."

--A. Cynkar