Effects of mindfulness-based interventions (MBIs) on psychological outcomes and HbA1C in patients with diabetes: A systematic review and meta-analysis of randomized controlled trials.

We synthesized the effects of MBIs on psychological outcomes and HbA1c in diabetic patients and conducted subgroup analyses to investigate the sources of heterogeneity. Nine electronic databases were methodically explored from their inception through May 2025. We reviewed studies on the outcomes for individuals with diabetes mellitus who participated in mindfulness-based interventions. A random-effects model was employed to calculate the effect size. The funnel plot, Q statistics, and I2 were employed to assess heterogeneity among studies. Across 24 primary studies (N = 1987), 942 participants engaged in mindfulness-based interventions and 955 functioning as controls. Mean age ranged from 18.3 to 66.3 years. Overall, mindfulness-based interventions showed improvement of HbA1c (Hedges' g = 0.564, 95%Confidence interval, CI, 0.221, 0.908, p = 0.001), stress (g = 1.132, 95%CI 0.551, 1.714, p < 0.001), anxiety (g = 1.321, 95%CI 0.569, 2.072, p = 0.001) and depression (g = 1.059, 95%CI 0.564, 1.555, p < 0.001). MBI format, intention-to-treat analysis, concealed allocation, attrition, funding sources, and a priori analysis were modifiers affecting the effect size. To sum up, mindfulness-based therapies markedly improved HbA1c levels and psychological outcomes, among individuals with diabetes mellitus. Future studies with robust designs are warranted. Healthcare professionals may consider using these therapies to improve psychological outcomes and HbA1c levels in individuals with diabetes mellitus.