The role of behavioural medicine in type 2 diabetes

A Special Section of the Annals of Behavioral Medicine focuses on novel evidence about type 2 diabetes management and the role of psychosocial factors: what are the learnings?

By Dr Christel Hendrieckx

This special section brings together four papers, each addressing a different aspect of type 2 diabetes management. The editorial by Byrne and Revenson summarizes the novel contribution of each paper and the take-away messages.

      • The first paper by Hoogendoorn et al, explores the links between distress, well-being, depression and self-care among 627 adults with suboptimal HbA1c. Most had very low household incomes and were from Hispanic and Black ethnic groups. General distress was most strongly related with lower engagement with diabetes self-care. More so than depression, diabetes distress, and well-being. This is somewhat surprising. Earlier research has shown that diabetes distress is related to self-care. The authors conclude that using a simple general distress tool in clinical practice may be effective.
      • Lee et al studied diabetes distress in 239 dyads (pairs), i.e. a person with type 2 diabetes and their supporter (family member). People with diabetes with high distress reported they received support for medical management, but less support for maintaining healthy habits. Supporters’ distress was related to the medical outcomes of the person with diabetes.
      • Mayberry et al, took a different approach in their research with 379 participants with type 2 diabetes and a person of their choice closest to them. They identified four types of family functioning: a) collaborative and helpful; b) satisfied with low involvement; c) want more involvement; and d) critical and harmful involvement. Diabetes outcomes were worse in the latter groups.
      • The final paper, by Andrea et al, is about the challenges in offering accessible, culturally appropriate diabetes care in rural areas in the US. It had already been shown that the Living Healthy peer coaching program reduced pain and improved physical functioning. In this paper, with 177 participants, they report that the program also reduced stress and depressive symptoms. These are encouraging findings. Living Healthy peer coaching could help those who have difficulties accessing professional diabetes care.

Each of these studies offers new insights. The first study focusses on a group of people who are often underrepresented in research. The other three show how family and peers can make a big difference to both the emotional well-being and self-care of people with type 2 diabetes.

To read more of our research about type 2 diabetes check out our previous blogs.


      • Byrne M, Revenson TA. Introduction to the Special Section: The Role of Behavioral Medicine in Improving Outcomes for People With Type 2 Diabetes. Ann Behav Med. 2021 Oct 4;55(10):935-937
      • Hoogendoorn CJ, Schechter CB, Llabre MM, Walker EA, Gonzalez JS. Distress and type 2 diabetes self-care: putting the pieces together. Ann Behav Med. 2021 Oct 4;55(10):938-948.
      • Lee AA, Heisler M, Trivedi R, et al. Diabetes distress among dyads of patients and their health supporters: links with functional support, metabolic outcomes, and cardiac risk. Ann Behav Med. 2021 Oct 4;55(10):949-955.
      • Mayberry LS, Greevy RA, Huang LC, Zhao S, Berg CA. Development of a typology of diabetes-specific family functioning among adults with type 2. Ann Behav Med. 2021 Oct 4;55(10):956-969.
      • Andreae SJ, Andreae LJ, Richman JS, Cherrington AL, Safford MM. Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial. Ann Behav Med.  2021 Oct 4;55(10):970-980.
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