SynthesisMedicine2026
The effect of cognitive behavioral therapy for sleep and glycemic outcomes in people with diabetes: A systematic review and meta-analysis.
Synthesis in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSleep disturbances are highly prevalent in individuals with diabetes and are associated with various adverse physiological, psychological, and social consequences. A growing body of research supports the effectiveness of cognitive behavioral therapy (CBT) in managing sleep problems in diabetes. However, the extent of its positive correlation with sleep quality and glycemic outcomes remains unclear due to the lack of rigorous evidence synthesis.
methodsTen databases (PubMed, Cochrane Library, EMBASE, CINAHL, Web of Science, MEDLINE, APA PsycInfo, China National Knowledge Infrastructure [CNKI], Wanfang Data Knowledge Service Platform, VIP) were searched using keywords related to cognitive behavioral therapy and diabetes, from their inception until June 2026, to identify eligible randomized controlled trials. Researchers independently screened and extracted data from the included studies. The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0). Random-effects meta-analyses were performed using Review Manager software (RevMan) 5.4.1 to estimate overall effects and for prespecified subgroup analyses. Sensitivity analysis, assessment of publication bias, and meta-regression were conducted using STATA 17.0 to explore study-level variables potentially contributing to heterogeneity.
resultsTen eligible randomized controlled trials involving a total of 2827 participants from 4 countries were included in this synthesis. When comparing CBT to usual care or health education, CBT demonstrated a significant effect size for improving sleep quality (mean difference [MD] = -1.47; 95% confidence interval [CI] = -1.98 to -0.96; P < .00001; I2 = 89%). Significant improvements were also observed for glycemic outcomes (HbA1c: MD = -0.35%; 95% CI = -0.44 to -0.25; P < .00001; I2 = 94%) and insomnia severity (MD = -2.06; 95% CI = -4.24 to 0.12; P = .004; I2 = 88%). However, there was no significant improvement in BMI (MD = -0.12; 95% CI = -0.72 to 0.48; P = .69; I2 = 0%). Exploratory subgroup analyses revealed significant differences based on follow-up time. Through meta-regression, disease type, sample size, and intervention plan were not found to be sources of heterogeneity.
conclusionCognitive behavioral therapy significantly improves sleep quality, reduces HbA1c levels, and alleviates insomnia severity in people with diabetes. Future high-quality research is needed to optimize protocols, define target populations, and facilitate wider clinical implementation.
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