Effectiveness of Acceptance and Commitment Therapy for type 2 Diabetes. A Systematic Review

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a metabolic condition with chronic uncontrolled treatment that comes with other psychological problems like diabetes distress, low self-efficacy, and self-care practices. ACT Acceptance and Commitment Therapy (ACT), third-wave behavioral treatment, has also been singled out due to its commitment to psychological flexibility and value-explicit conduct, which could be helpful to patients with T2DM.

Aim: The aim of the review was to determine the extent to which ACT could enhance diabetes distress, self-care behaviors, psychological flexibility, self-efficacy, and glycemic control (HbA1c levels) among adults with type 2 diabetes.

Method: Systematic review has been performed on randomized controlled studies (RCTs) with a search of five databases, including PubMed, Scopus, PsycINFO, ScienceDirect, and Google Scholar, including research papers published between 2014 to 2024. A synthesis of 10 studies meeting the inclusion criteria was done, and the quality was evaluated by using an assessment matrix. The final review was composed of ten RCTs with various delivery formats and different intervention length.

Results: The results were always in line that ACT had a powerful impact in decrease of diabetes distress and advancement of mental adaptability, self-care actions and self-efficacy. Moderate declines in the levels of HbA1c were also reported in several studies. Actual and virtual ACT interventions were identified to be possible, but retention was not consistent. In comparison treatment, the studies indicated that ACT was not inferior to the other interventional procedures like mindfulness-based therapy and emotion-focused therapy.

Conclusion: The study seems to suggest that ACT is a not only effective but also versatile psychological intervention among T2DM adults with emotional and behavioral outcomes. It is advised that larger scale trials should be done in future to establish long term benefits.

Keywords: Type 2 diabetes, Acceptance and Commitment Therapy, psychological flexibility, diabetes distress, self-care, self-efficacy, HbA1c, RCT.