Date of Award
2027
Document Type
Capstone
Degree Name
Master of Science (MS)
Department
Physician Assistant Studies
Committee Chair
Ashley Kernicky
Abstract
Introduction: Type 1 diabetes (T1D) carries significant psychological burden, including elevated rates of anxiety and diabetes-related distress. Both of these have been linked to worse glycemic control and outcomes. The purpose of this clinical review is to evaluate the current evidence on whether non-pharmacologic interventions, such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based interventions (MBI), are associated with meaningful reductions in HbA1c in adults with T1D and elevated anxiety.
Methods: PubMed was searched using key terms including “type 1 diabetes,” “anxiety,” “non-pharmacologic interventions,” and “glycemic control,” with MeSH terms and Boolean operators applied. The applied filters narrowed the results to four relevant, high-quality articles for review.
Results: Three of the four included studies reported small but statistically significant HbA1c reductions associated with non-pharmacologic interventions. The HbA1c reductions across these three studies ranged from -0.25% to -0.26%. CBT-based interventions showed the most consistent findings in HbA1c reduction. One randomized controlled trial found no significant HbA1c benefit. Several studies also reported improvements in psychological outcomes including diabetes-related distress and psychological flexibility.
Discussion: Current evidence suggests that non-pharmacologic interventions may offer some benefit for glycemic control in people with T1D, as well as psychological benefits, though glycemic effects are small and findings are mixed. Larger, well-designed studies specifically enrolling adults with T1D and elevated anxiety are needed to clarify the clinical impact of these interventions.
Recommended Citation
Merr S. The Effects of Non-Pharmacologic Interventions on Glycemic Control in Type 1 Diabetes and Anxiety: A Clinical Review. The PA Department Journal of Medical Science. 2026. https://digitalcommons.gardner-webb.edu/pa-department-journal-of-medical-science/93
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