The relationships between mindfulness, diabetes-related distress, selected demographic variables, and self-management in adults with Type 2 diabetes

Type 2 diabetes is a disease of worldwide scope and epidemic proportion. Two hundred and eighty-five million individuals have been diagnosed worldwide--a number expected to rise to 330 million by 2025 (Unwin, Whiting, & Roglic, 2010) and to 366 million by 2030 (Adriaanse et al., 2008). It is estimated that 18.8 million diagnosed and 7.0 million undiagnosed Americans have type 2 diabetes, numbers expected to rise to a total of 48.3 million by 2050 (Centers for Disease Control [CDC], 2011; Geiss & Cowie, 2011; Narayan, Williams, Gregg, & Cowie 2011). A recent American Diabetes Association (ADA) report estimated that the total costs of diabetes related health care rose from $174 billion in 2007 to $245 billion in 2012--figures that underscore the significant social costs associated with the disease (ADA, 2013). The considerable personal, social, and financial tolls of type 2 diabetes make effective self-management imperative. Diabetes-related distress (DRD) and mindfulness are two variables that are believed to significantly impact effective diabetes self-management yet more research is needed to better understand and empirically confirm these relationships. DRD is characterized by the negative emotional reactions to the diabetes diagnosis, threat of complications, self-management demands, and unsupportive interpersonal relationships (Polonsky et al., 1995, 2005; Gonzalez, Fisher, & Polonsky, 2011). Recent studies indicate the relevance of mindfulness, the mindfulness components of awareness and acceptance, and the use of mindfulness-based interventions to enhance the self-management behaviors of individuals with type 2 diabetes (Gregg, Callaghan, Hayes, & Glenn-Lawson, 2007; Hernandez, Bradish, Rodger, & Rybansky, 1999; Ingadottir & Halldorsdottir, 2008). However, to date the literature is incomplete in drawing an explicit connection between mindfulness, diabetes-related distress, and diabetes self-management. This study was designed to address this gap in the literature. The prevalence of type 2 diabetes, its related debilitating conditions (e.g., cardiovascular disease, vascular dementia, kidney disease, and diabetic retinopathy), and mental health implications, make the exploration of self-management pathways imperative so that counselors and counselor educators may develop a greater understanding of the type 2 diabetes condition and appropriate counseling approaches. Greater understanding of the mechanisms to better diabetes self-management, with mindfulness as the theoretical foundation, may pave the way for improved prevention and intervention efforts among health care and mental health professionals. The results of the current study indicated that mindfulness is a statistically significant predictor of self-management. Further, the results indicated social support as a significant predictor of self-management. The results suggest the potential value of the clinical application of mindfulness-based interventions with the type 2 diabetes population and continued development of resources that provide positive social support for the millions of people who are affected by this disease