Cognitive-behavioral group therapy for obesity to reduce cardiovascular risks in patients with type 2 diabetes
https://doi.org/10.15829/1728-8800-2023-3707
EDN: KBIRTQ
Abstract
Obesity is one of the risk factors for the development and progression of type 2 diabetes (T2D). Decrease in body weight (BW) by 10% from the initial level in patients with T2D and obesity significantly reduces the risk of cardiovascular events. Low effectiveness of measures to reduce body weight in patients with T2D is due to hidden eating disorders against the background of mental imbalance, high levels of anxiety and depression, and frustration with glycemic levels. Solving the problem of the low frequency of achieving target values for reducing weight in type 2 diabetes through the development and evaluation of the clinical effectiveness of cognitive-behavioral therapy protocols is of high scientific and practical significance.
About the Authors
S. O. EliashevichRussian Federation
Moscow
E. O. Stepanova
Russian Federation
Moscow
O. M. Drapkina
Russian Federation
Moscow
References
1. Galstyan GR, Shestakova EA, Sklyanik IA. Obesity and type 2 diabetes mellitus: finding a compromise therapeutic solution. Diabetes mellitus. 2017;20(4):270-8. (In Russ.) doi:10.14341/DM8726.
2. Chazova IE, Oshchepkova EV, Zhernakova Yu V. Diagnosis and treatment of arterial hypertension. Eurasian Journal of Cardiology. 2015;(2):3-30. (In Russ.) Ч
3. Alferova VI, Mustafina SV. The prevalence of obesity in the adult population of the Russian Federation (literature review). Obesity and metabolism. 2022;19(1):96-105. (In Russ.) doi:10.14341/omet12809.
4. Dedov II, Shestakova MV. Diabetes mellitus is a global medical and social problem of our time. Consilium medicum. 2009;11(12):5-8. (In Russ.)
5. Dedov II, Shestakova MV, Vikulova OK, et. al. Epidemiological characteristics of diabetes mellitus in the Russian Federation: clinical and statistical analysis according to the data of the diabetes registry as of 01.01. 2021. Diabetes mellitus. 2021;24(3):204-21. (In Russ.) doi:10.14341/DM12759.
6. Dedov II, Omelyanovsky VV, Shestakova MV, et al. Diabetes mellitus as an economic problem in the Russian Federation. Diabetes mellitus. 2016;19(1):30-43. (In Russ.) doi:10.14341/DM7784.
7. Dedov II, Kalashnikov MF, Belousov DYu, et al. Analysis of the cost of type 2 diabetes mellitus in the Russian Federation: results of the Russian multicenter observational pharmacoepidemiological study FORESIGHT-DM2. Diabetes mellitus. 2017;20(6):403-19. (In Russ.) doi:10.14341/DM9278.
8. Klein S, Gastaldelli A, Yki-Järvinen H, et al. Why does obesity cause diabetes? Cell Metab. 2022;34(1):11-20. doi:10.1016/j.cmet.2021.12.012.
9. Pi-Sunyer X. The look AHEAD trial: a review and discussion of its outcomes. Current nutrition reports. 2014;(3):387-91. doi:10.1007/s13668-014-0099-x.
10. Lean ME, Leslie WS, Barnes AС, et al. Two-year results of the randomised Diabetes Remission Clinical Trial (DiRECT). Lancet Diabetes Endocrinol. 2019;7(5):344-55. doi:10.1016/S22138587(19)30068-3.
11. Chapman A, Liu S, Merkouris S, et al. Psychological interventions for the management of glycemic and psychological outcomes of type 2 diabetes mellitus in China: a systematic review and metaanalyses of randomized controlled trials. Front Public Health. 2015;(3):252. doi:10.3389/fpubh.2015.00252.
12. Sakovskaya SG. Depression and stress in patients with type 2 diabetes. Problems of modern medicine: topical issues. 2016;307-10. (In Russ.)
13. Pogosova NV. Psychosocial aspects in cardiological rehabilitation: from theory to practice. Consensus Document of the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. Kardiologiia. 2015;55(10):96-108. (In Russ.)
14. Winchester RJ, Williams JS, Wolfman TE, et al. Depressive symptoms, serious psychological distress, diabetes distress and cardiovascular risk factor control in patients with type 2 diabetes. JDС. 2016;30(2):312-7. doi:10.1016/j.jdiacomp.2015.11.010.
15. Belyakova NA, Mikhailova DG, Tsvetkova IG, et al. Psychoneurological features of patients with type 2 diabetes mellitus with peripheral neuropathy. Diabetes mellitus. 2010;(4):39-41. (In Russ.)
16. Drapkina OM, Kontsevaya AV, Kalinina AM, et al. 2022 Prevention of chronic non-communicable diseases in the Russian Federation. National guidelines. Cardiovascular Therapy and Prevention. 2022;21(4):3235. (In Russ.) doi:10.15829/1728-8800-2022-3235. EDN DNBVAT.
17. Golovacheva VA, Parfenov VA. Modern tactics of managing patients with diabetic polyneuropathy. Pharmateka. 2016;5(318):30-7. (In Russ.) Г
18. Dalle Grave R, Sartirana M, Calugi S. Personalized cognitivebehavioural therapy for obesity (CBT-OB): theory, strategies and procedures. Biopsychosoc Med. 2020;14(1):1-8. doi:10.1186/s13030-020-00177-9.
19. Samsonova GO, Yazykova TA, Agasarov LG. Psychological aspects of alimentary obesity (literature review). Bulletin of new medical technologies. Electronic edition. 2018;12(3):133-9. (In Russ.) Самсонова Г. О., Языкова Т. А., Агасаров Л. Г. Психологические аспекты алиментарного ожирения (обзор литературы). Вестник новых медицинских технологий. Электронное издание. 2018;12(3):133-9. doi:10.24411/2075-4094-2018-16027.
20. Yang X, Li Z, Sun J. Effects of cognitive behavioral therapy– based intervention on improving glycaemic, psychological, and physiological outcomes in adult patients with diabetes mellitus: a meta-analysis of randomized controlled trials. Front Psychiatry. 2020;(11):711. doi:10.3389/fpsyt.2020.00711.
21. Abbas Q, Latif S, Habib HA, et al. Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: a randomized control trial. BMC Psychiatry. 2023;23(1):86. doi:10.1186/s12888-023-04546-w.
22. Dalle Grave R, Calugi S, Dollet HA, et al. Enhanced cognitive behaviour therapy for adolescents with anorexia nervosa: an alternative to family therapy? Behav Res Ther. 2013;51(1):9-12. doi:0.1016/j.brat.2012.09.010.
23. Hay P, Palavras MA, da Luz FQ, et al. Physical and mental health outcomes of an integrated cognitive behavioural and weight management therapy for people with an eating disorder characterized by binge eating and a high body mass index: a randomized controlled trial. BMC Psychiatry. 2022;22(1):1-14. doi:10.1186/s12888-022-04005-y.
24. Bassi G, Gabrielli S, Donisi V, et al. Assessment of psychological distress in adults with type 2 diabetes mellitus through technologies: literature review. JMIR. 2021;23(1):17740. doi:10.2196/17740.
25. Clarke J, Sanatkar S, Baldwin PAndrew, et al. A web-based cognitive behavior therapy intervention to improve social and occupational functioning in adults with type 2 diabetes (the springboard trial): randomized controlled trial. JMIR. 2019;21(5):12246. doi:10.2196/12246.
26. Calugi S, Ruocco A, Ghoch ME, et al. Residential cognitivebehavioral weight-loss intervention for obesity with and without binge‐eating disorder: A prospective case–control study with five-year follow-up. Int J Eat Disord. 2016;49(7):723-30. doi:10.1002/eat.22549.
27. Golovacheva VA, Parfenov VA. Anxiety disorders under the guise of vegetovascular dystonia. Medical advice. 2017;(17):26-30. (In Russ.)
28. Irandoust K, Taheri M, Hamzehloo K, et al. The effects of cognitive behavioral therapy on selected physical, physiological parameters, exercise and nutritional behaviors in diabetic persons. Eur Rev Med Pharmacol Sci. 2022;26(18):6805-12. doi:10.26355/eurrev_202209_29782.
Supplementary files
What is already known about the subject?
- Obesity and type 2 diabetes (T2D) are mutually aggravating diseases.
- Reducing body weight (BW) by 10% from baseline in patients with T2D and obesity significantly reduces the risk of cardiovascular events.
- Patients with T2D often experience eating disorders that aggravate underlying disease.
- High levels of anxiety and depression, hidden eating disorders in people with T2D and obesity hinder the effective reduction of body weight.
What might this study add?
- Cognitive-behavioral therapy is an effective means of helping individuals with T2D with mental problems, anxiety, depressive, and eating disorders.
- The inclusion of cognitive behavioral therapy in a comprehensive treatment program for patients with T2D and obesity contributes to the recommended reduction in BW, improving quality of life and adherence to treatment.
Review
For citations:
Eliashevich S.O., Stepanova E.O., Drapkina O.M. Cognitive-behavioral group therapy for obesity to reduce cardiovascular risks in patients with type 2 diabetes. Cardiovascular Therapy and Prevention. 2023;22(9):3707. (In Russ.) https://doi.org/10.15829/1728-8800-2023-3707. EDN: KBIRTQ