Trial reportPatient education and counseling2026
How does addressing diabetes distress lead to positive glycemic change? Results from the EMBARK trial.
Trial report in Patient education and counseling, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Living with what is lost: reframing emotional life with diabetes through an integrative perspective on loss and grief.Frontiers in clinical diabetes and healthcare · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveTo document the effectiveness of diabetes distress (DD) interventions and to suggest how the improvements in DD, documented in a previous report, led to improved glycemic outcomes.
methodsIndividuals with T1D (n = 276) with elevated DD (>2 on T1 Diabetes Distress Scale) and HbA1c (>7.5 %) were assigned to: (1) StreamLine, a diabetes self-management program; (2) TunedIn, an ACT-based (Acceptance and Commitment Therapy), emotion-focused DD program; or (3) FixIt, an integration of Streamline and TunedIn. Previous research had shown reduced DD (Stage 1) and improved glycemic outcomes (Stage 4) from baseline to 12-months. Here we assess two intermediate stages: adoption of a new emotional perspective (Stage 2) and improvements in diabetes-related problem solving (Stage 3). A structural equation model was specified to evaluate a hypothesized, 4-stage model of change.
resultsImprovements occurred in all three interventions at all 4 stages. TunedIn and FixIt, however, compared to StreamLine, displayed greater improvements in Stages 1 through 3; while StreamLine and TunedIn displayed greater improvements in glycemic outcomes than FixIt. Associations between reductions in DD and glycemic change were explained through improvements in emotional perspective taking and problem solving.
conclusionAlthough all three intervention groups showed improvement, TunedIn demonstrated the most comprehensive benefits. Findings indicate how reductions in diabetes distress, documented in a previous report, are linked with improved glycemic outcomes through changes in emotional perspective-taking, which then allow for improved diabetes-related problem solving. This sequence can form the basis for designing effective intervention programs to reduce DD and improve overall diabetes management.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.