Evidence map›Paper›PMID 41681035›Full record

ReviewDiabetic medicine : a journal of the British Diabetic Association2026

Group-based interventions to reduce diabetes distress in adults with type 1 diabetes: A rapid realist review of the Reduce and TunedIn interventions.

Sarah Sims, Vibeke Stenov, Mette Due-Christensen, Lawrence Fisher, Clara Fabian-Therond, Megan Peck, Shalini Ahuja, Siobhan O'Connor, Ruth Abrams, Jennifer Halliday and 5 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Diabetic medicine : a journal of the British Diabetic Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Sarah SimsKing's College London, London, UK.ORCID https://orcid.org/0000-0001-7494-9030
Vibeke StenovNAMU - National Center for Applied Research in Older Citizens Living with Multimorbidity, Univeristy College Absalon, Denmark.
Mette Due-ChristensenSteno Diabetes Center Copenhagen, Region H, Copenhagen, Denmark.
Lawrence FisherUniversity of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-9481-9727
Clara Fabian-TherondKing's College London, London, UK.
Megan PeckKing's College London, London, UK.
Shalini AhujaKing's College London, London, UK.
Siobhan O'ConnorKing's College London, London, UK.
Ruth AbramsUniversity of Surrey, Guildford, UK.
Jennifer HallidaySchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
Richard I G HoltUniversity of Southampton, Southampton, UK.ORCID https://orcid.org/0000-0001-8911-6744
Jane SpeightSchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.ORCID https://orcid.org/0000-0002-1204-6896
Jackie SturtKing's College London, London, UK.ORCID https://orcid.org/0000-0003-1281-1401
Ruth HarrisKing's College London, London, UK.
D‑Stress Study Group

Funding

Diabetes UKNational Institute for Health and Care Research
6 · The paper itself

Abstract

aimsDiabetes distress is highly prevalent among adults with type 1 diabetes, yet remains under-recognised and rarely addressed in routine diabetes care. This rapid realist review aimed to identify how, why, for whom, and in what contexts group-based interventions reduce elevated diabetes distress in adults with type 1 diabetes, to inform the co-adaption of a new diabetes distress intervention in the UK ('D-Stress Reduce').

methodsFollowing established rapid realist review methods, we synthesised evidence from 27 papers relating to two existing diabetes distress interventions and the psychological and social theories underpinning them. Data extraction and analysis focused on identifying contexts, mechanisms and outcomes, supported by stakeholders including methodological experts and programme architects.

resultsSeven programme theories were generated and articulated through 20 'If-Then-Because' statements. Key theories highlighted emotional regulation, peer support and person-centred facilitation in reducing diabetes distress. Other theories included regular assessment and follow-up, motivation for action, and empowerment in self-management. The review found that interventions were most effective when adults with type 1 diabetes reported feeling emotionally safe, listened to and respected, and when group facilitators shifted from directive, hierarchical communication styles to collaborative approaches. Contextual factors, such as group composition, facilitator skill, and individual readiness for change influenced outcomes.

conclusionsThis review provides a theory-driven foundation for developing, implementing and evaluating a new co-adapted diabetes distress intervention in the UK ('D-Stress Reduce') and highlights multiple components that can be addressed to improve the care pathway and group-based experience.

Indexed as

Diabetes Mellitus, Type 1Psychological DistressPsychological TheoryPsychotherapy, GroupStress, PsychologicalHealth Plan ImplementationHumansPatient-Centered CareSelf-ManagementSocial SupportUnited Kingdomdiabetes distressrealist process evaluationrealist reviewtype 1 diabetes

Identifiers

PMID41681035
PMCPMC13614002

What OpenQuestion holds

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Registered trials

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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.