Document Type : Call for papers in English


1 Clinical psychology faculty. Semnan university.Semnan.Iran

2 Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.

3 Department of Educational psychology, Faculty of psychology and Educational Sciences, Semnan University, Semnan, Iran.


Aim: Non-pharmacological treatment models are offered to the diabetics to better manage their diabetes and blood sugar. This study compared two popular treatments which are evidenced to have an acceptable effect on diabetes. The purpose of this study was to compare the effectiveness of acceptance and commitment therapy (ACT) and health-promoting lifestyle intervention or diabetes self-management program (DSMP) in the management of HbA1c.
Methods: A total of 60 patients referred to Tehran Diabetes Treatment centers were selected by convenience sampling and were assigned to three 20-member groups. The first group received ACT intervention, the second group received DSMP intervention, and the third group did not receive any intervention. All the three groups received relevant medications during the study. They were examined for glycated hemoglobin in the three phases of before the intervention, after the intervention and follow-up using blood tests. The data were analyzed using descriptive statistics and mixed-design analysis of variance
Results:. The results showed that both ACT and DSMP methods were effective in improving the Management of Glycated Hemoglobin Levels in Type 2 Diabetes (F=5.835, P value<0.005). In addition, the effectiveness was sustained until the follow-up phase (F=26.274, P value<0.001). However, the comparison of the two treatments showed that ACT was more effective than DSMP in post-test and follow-up phases (F=10.902, P value<0.001).
Conclusion:. It seems that along with pharmacological treatments, ACT could be significantly effective in the management of glycated hemoglobin levels. Glycated hemoglobin levels were better managed with the lifestyle modification by ACT than DSMP


Adu, M. D., Malabu, U. H., Malau-Aduli, A. E. O., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PloS one14(6), e0217771.
American Diabetes Association (2020). Standards of Medical Care in Diabetes-2020 Abridged for Primary Care Providers. Clinical diabetes: a publication of the American Diabetes Association38(1), 10–38.
Ataie Moghanloo, V., Ataie Moghanloo, R., & Moazezi, M. (2015). Effectiveness of Acceptance and Commitment Therapy for Depression, Psychological Well-Being and Feeling of Guilt in 7 - 15 Years Old Diabetic Children. Iranian journal of pediatrics25(4), e2436.
Baroni, I., Caruso, R., Dellafiore, F., Ausili, D., Barello, S., Vangone, I., Russo, S., Magon, A., Conte, G., Guardamagna, L., & Arrigoni, C. (2022). Self-care and type 2 diabetes mellitus (T2DM): a literature review in sex-related differences. Acta bio-medica: Atenei Parmensis, 93(4), e2022277.
Cardel, M. I., Ross, K. M., Butryn, M., Donahoo, W. T., Eastman, A., Dillard, J. R., Grummon, A., Hopkins, P., Whigham, L. D., & Janicke, D. (2020). Acceptance-based therapy: the potential to augment behavioral interventions in the treatment of type 2 diabetes. Nutrition & diabetes10(1), 3.
Chawla, R., Madhu, S. V., Makkar, B. M., Ghosh, S., Saboo, B., Kalra, S., & RSSDI-ESI Consensus Group (2020). RSSDI-ESI Clinical Practice Recommendations for the Management of Type 2 Diabetes Mellitus 2020. Indian journal of endocrinology and metabolism24(1), 1–122.
González-Rivas, J. P., Pavlovska, I., Polcrova, A., Nieto-Martínez, R., & Mechanick, J. I. (2022). Transcultural Lifestyle Medicine in Type 2 Diabetes Care: Narrative Review of the Literature. American journal of lifestyle medicine, 17(4), 518–559. 10.1177/15598276221095048
Goyal, R, & Jialal, I. (2023). Type 2 Diabetes. [Updated 2023 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.
Gregg, J A., Callaghan, G. M., Hayes, S C., & Glenn-Lawson, J L. (2007b). The Diabetes Lifestyle Book: Facing Your Fears and Making Changes for a Long and Healthy Life. Oakland: New Harbinger Publications.
Gregg, J. A., Callaghan, G. M., Hayes, S. C., & Glenn-Lawson, J. L. (2007a). Acceptance and Commitment therapy for Diabetes self-management. Therapist manual. Washington, D.C: San Jose State University.
Hapunda, G. (2022). Coping strategies and their association with diabetes specific distress, depression and diabetes self-care among people living with diabetes in Zambia. BMC endocrine disorders22(1), 215.
Hayes, S. C. (2019). Acceptance and commitment therapy: towards a unified model of behavior change. World psychiatry: official journal of the World Psychiatric Association (WPA)18(2), 226–227.
Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior therapy, 44(2), 180–198.
Kalra, S., Jena, B. N., & Yeravdekar, R. (2018). Emotional and Psychological Needs of People with Diabetes. Indian Journal of Endocrinology and Metabolism, 22(5), 696–704.
Khodakarami, R., Abdi, Z., Ahmadnezhad, E., Sheidaei, A., & Asadi-Lari, M. (2022). Prevalence, awareness, treatment and control of diabetes among Iranian population: results of four national cross-sectional STEPwise approach to surveillance surveys. BMC public health, 22(1), 1216.
Kioskli, K., Scott, W., Winkley, K., Godfrey, E., & McCracken, L. M. (2020). Online Acceptance and Commitment Therapy for People with Painful Diabetic Neuropathy in the United Kingdom: A Single-Arm Feasibility Trial. Pain medicine (Malden, Mass.), 21(11), 2777–2788.
Maghsoudi, Z., Razavi, Z., Razavi, M., & Javadi, M. (2019). Efficacy of Acceptance and Commitment Therapy for Emotional Distress in The Elderly with Type 2 Diabetes: A Randomized Controlled Trial. Diabetes, metabolic syndrome and obesity : targets and therapy12, 2137–2143.
Mustapa, A., Justine, M., & Manaf, H. (2022). Effects of patient education on the quality of life of patients with type 2 diabetes mellitus: A scoping review. Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia, 17(3), 22–32.
Nasri, M., & Nasri, M. (2017). The Effectiveness of Transdiagnostic Treatment on Cognitive Flexibility, Emotion Regulation and Hb Factor in Patients with Type 2 Diabetes. Psychological Achievements, 24(2), 81-100. doi: 10.22055/psy.2018.20969.1741
Page-Reeves, J., Murray-Krezan, C., Burge, M. R., Mishra, S. I., Regino, L., Bleecker, M., Perez, D., McGrew, H. C., Bearer, E. L., & Erhardt, E. (2023). A patient-centered comparative effectiveness research study of culturally appropriate options for diabetes self-management. medRxiv: the preprint server for health sciences, 2023.01.31.23285236.
Rahimian Boogar, I., Mohajeri-Tehrani, M. R., Besharat, M. A., & Talepasand, S. (2013). The effect of sociostructural and collaborative decision-making on diabetes self-management. Iranian journal of public health, 42(3), 280–292.
Ryan, A. K., Pakenham, K. I., & Burton, N. W. (2020). A pilot evaluation of a group acceptance and commitment therapy‐informed resilience training program for people with diabetes. Australian Psychologist, 55(3), 196-207.
Sakamoto, R., Ohtake, Y., Kataoka, Y., Matsuda, Y., Hata, T., Otonari, J., Yamane, A., Matsuoka, H., & Yoshiuchi, K. (2022). Efficacy of acceptance and commitment therapy for people with type 2 diabetes: Systematic review and meta-analysis. Journal of diabetes investigation, 13(2), 262–270.
Shayeghian, Z., Hassanabadi, H., Aguilar-Vafaie, M. E., Amiri, P., & Besharat, M. A. (2016). A Randomized Controlled Trial of Acceptance and Commitment Therapy for Type 2 Diabetes Management: The Moderating Role of Coping Styles. PloS one11(12), e0166599.
Shiferaw, W. S., Akalu, T. Y., Desta, M., Kassie, A. M., Petrucka, P. M., & Aynalem, Y. A. (2021). Effect of educational interventions on knowledge of the disease and glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials. BMJ open11(12), e049806. bmjopen-2021-049806
Upsher, R., Onabajo, D., Stahl, D., Ismail, K., & Winkley, K. (2021). The Effectiveness of Behavior Change Techniques Underpinning Psychological Interventions to Improve Glycemic Levels for Adults with Type 2 Diabetes: A Meta-Analysis. Frontiers in clinical diabetes and healthcare2, 699038.
Valenzano, M., Cibrario Bertolotti, I., Grassi, G., Broglio, F., & Valenzano, A. (2023). Predicting Glycated Hemoglobin Through Continuous Glucose Monitoring in Real-Life Conditions: Improved Estimation Methods. Journal of diabetes science and technology, 17(4), 998–1007.
van der Feltz-Cornelis, C., Allen, S. F., Holt, R. I. G., Roberts, R., Nouwen, A., & Sartorius, N. (2021). Treatment for comorbid depressive disorder or subthreshold depression in diabetes mellitus: Systematic review and meta-analysis. Brain and behavior, 11(2), e01981.
Werfalli, M., Raubenheimer, P. J., Engel, M., Musekiwa, A., Bobrow, K., Peer, N., Hoegfeldt, C., Kalula, S., Kengne, A. P., & Levitt, N. S. (2020). The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review. Systematic reviews, 9(1), 133.
Zandi, A., Dinpanah-Khoshdarehgi, H., Madahi, M., & Jomehri, F. (2023). Comparing the Effect of Acceptance and Commitment Therapy and Reality Therapy on Hemoglobin A1c in Type 2 Diabetic Patients. International Journal of Behavioral Sciences, 16(4), 248-254. doi: 10.30491/ijbs.2023.365143.186