Comparison of the effects of Korean mindfulness-based stress reduction, walking, and patient education in diabetes mellitus

Nurs Health Sci. 2015 Dec;17(4):516-25. doi: 10.1111/nhs.12229. Epub 2015 Aug 14.


The purpose of this study was to compare the effects of Korean mindfulness-based stress reduction (K-MBSR), walking, and patient education regarding diabetes mellitus (DM) on stress response, glycemic control, and vascular inflammation in patients with diabetes mellitus. A cluster randomized trial including 56 adults with diabetes mellitus (K-MBSR group = 21, walking group = 18, patient education group = 17) was conducted between 13 July and 14 September 2012. The questionnaire included the Diabetes Distress Scale and Perceived Stress Response Inventory. Fasting blood samples were used to measure levels of cortisol, blood glucose, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (t-PA). There were no statistically significant differences between the effects of K-MBSR, walking, and patient education on stress, glycemic control, or vascular inflammation. However, in the K-MBSR and walking groups, significant reductions in the levels of serum cortisol and PAI-1 were observed. A significant reduction in psychological responses to stress was observed in the walking and patient education groups. Longitudinal studies could provide better insight into the impact of K-MBSR, walking, and patient education on health outcomes in adults with diabetes mellitus.

Keywords: diabetes mellitus; meditation; mindfulness; rural population; stress; walking.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Attitude to Health
  • Blood Glucose / analysis
  • Chi-Square Distribution
  • China
  • Cluster Analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / rehabilitation
  • Educational Status
  • Exercise / physiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mindfulness / methods*
  • Patient Education as Topic / methods*
  • Prospective Studies
  • Risk Assessment
  • Rural Population
  • Socioeconomic Factors
  • Stress, Psychological / prevention & control*
  • Treatment Outcome
  • Walking / physiology


  • Blood Glucose