The cognitive-behavioural training, compliance and metabolic status among patients with diabetes type 2. Pilot study

Abstract

Background: Enforcing medical recommendations in patients with diabetes is a necessity, not a well thought-out choice – therefore typical intervention based on models of health behaviors seems to be insufficient. We focused our research on cognitive-behavioral intervention, which was oriented on enhancing self-efficacy related to the ability of changing health-related behaviors (i.a. time planning, problem solving, changing automatic negative thoughts). Methods: Intensive longitudinal study included 15 patients with type 2 diabetes and obesity. During 3 months, patients participated in a weekly cognitive-behavioral sessions, where they developed general skills in time planning, problem solving and changing negative automatic thoughts. In the next two months, participants had a chance to use telephone consultation. Metabolic profile, glycemic level, body mass, mood, distress, level of health related behaviors and level of self-efficacy in the scope of acquired cognitive-behavioral skills were monitored. Findings: Better average glycemy rebalance was correlated with lower levels of distress, anxiety and depression, and this relations were moderated by self-efficacy related to the scope of using cognitive-behavioral skills. Stabilization of blood sugar concentration on desired level occurred averagely after 9 weeks and its predictors were: self-efficacy related to cognitive-behavioral skills, moderate level of distress, decrease of body mass, implementation of physical activity and decrease of depression. Decrease of body mass and improvement of metabolic parameters were observed in all participants. Conclusions: Self-efficacy related to time planning, problem solving and examining negative automatic thoughts skills may conduce implementing and maintaining medical recommendations in type 2 diabetes patients.