ABSTRACTDiabetes type 2 (T2D) is characterized by the body’s inability to utilize insulin causing blood glucose to become elevated. T2D requires patients to change their lifestyle and diet, which can affect mental health by increasing symptoms of depression, anxiety, and/or stress (1). Depression and anxiety make it difficult for patients to effectively manage their T2D . Mindfulness is a technique that patients can use in their everyday lives to improve their mental health by reducing anxiety and managing stress. The purpose of this MSN project was to use evidence-based information to form an educational booklet for patients that provides instruction about various methods patients can use to practice mindfulness and a list of the benefits.

PICO QUESTIONIn newly diagnosed adults with type II diabetes (P), how does mindfulness-based stress reduction (I) compared to no mindfulness-based stress reduction(C) affect adherence in the first year (T)?.

LITERATURE REVIEWA literature review was conducted to determine the efficacy of mindfulness on mental health among patients with T2D and methods used to practice mindfulness. • Patient with T2D show an increase in

depression and anxiety(2).• Mindfulness-based stress reduction (MBSR)

and mindfulness-based cognitive therapy (MBCT) both reduce anxiety and symptoms of depression in patients with T2D (3), (4).

• Yoga and mindful walking decrease cortisol, which improves A1C (5), (6).

Controlling Anxiety with Mindfulness in Adults with Type II Diabetes to

Improve Blood Sugar Control Brandi Hively, BSN, RN, MSN Student

Plan and ImplementationBooklet will be given to patients with newlydiagnosed T2D in a hospital setting thatincludes: • Brief overview of T2D• Introduction to mindfulness• Three meditation activities• Six yoga poses with pictures and step-by-

step introduction• Additional resources for diabetes and

mindfulness

EvaluationPatients will have their A1c collected, take the Five Facet Mindfulness Questionnaire before pre-treatment, at 6-months, and 1-yr.

THEORETICAL FRAMEWORKCognitive theory focuses on using cognitive restructuring to improve cognitive distortions. Using mindfulness, patients bring awareness to their thoughts with no judgment or expectation and let go of distorted thoughts that are causing anxiety and distress. Patients can use cognitive theory to focus on the current moment and taking life one day at a time as opposed to focusing on the possible complications of T2D (7).

CONCLUSIONSPatients with newly diagnosed diabetes feel stressed and anxious. Patients have to make large lifestyle changes, such as diet changes or giving self-injections of insulin, in order to manage the disease. Often healthcare overlooks the mental effect of a diagnosis of a chronic disease like diabetes, mindfulness can be used to help mental illness by reducing anxiety and depression (1).

REFERENCES1. Enstad, C. J., Kreitzer, M.J., Vazquez-Benitez, G., & Whitebird, R.R. (2017).

Reducing diabetes distress and improving self-management with mindfulness. Social Work in Health Care, 57(1), 48-65. doi: 10.1080/00981389.2017.1388898

2. Nefs, G., Nyklicek, I., Pop, V. J., Pouwer, F., Son, J. V., & Speight, J. (2014). The association between mindfulness and emotional distress in adults with diabetes: Could mindfulness act as a buffer? Results from diabetes MILES: The Netherlands. Journal of Behavioral Medicine, 38, 251-260. doi: 10.1007/s10865-014-9592-3

3. Fournier, C., Khoury, B., Rush, S.E., & Sharma, M. (2015). Mindfulness-based stress reduction in healthy individuals: A meta-analysis. Journal of Psychosomatic Research, 78, 519-528. doi: 10.1016/j.psychores.2015.03.009

4. Blonk, M.C., Erdsteick, R.J., Nyklicek, I., Pop, V.J., Pouwer, F., Son, J.V., . . . Toorians, A.W. (2013). The effects of mindfulness-based interventions on emotional distress, quality of life, and HbA1c in outpatients with diabetes (DiaMind): A randomized controlled trail. Diabetes Care, 36, 823-830. doi: 10.2337/dc12-1477

5. Pascoe, M.C., Ski, C.F., & Thompson, D.R. (2017). Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology, 86, 152-168. doi: 10.1016/j.psyneuen.2017.08.008

6. Jung, H.Y., Lee, H., & Park, J. (2015). Comparison of the effects of Korean mindfulness-based stress reduction, walking and patient education in diabetes mellitus. Nursing and Health Sciences, 17, 516-525. doi: 10.1111/nhs.12229

7. Beck, A.T., & Haigh, E.A.P. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual Review of Clinical Psychology, 10, 1-24. doi: 10.1146/annurev-clinpsy-032813-153734

PROJECT METHODOLOGYPatients with newly diagnosed T2D feel overwhelmed with lifestyle changes that are required to effectively control blood glucose. Mindfulness can be a tool to manage stress and reduce anxiety and depression. A literature review revealed evidence that mindfulness can be used to improve mental health, which could improve glucose control and overall health. Mindfulness is a cost-effective method for patients to use to reduce anxiety and depression, this project focused on using mindfulness to reduce diabetes distress.