Psychological interventions do not appear to work better than usual care in relieving diabetes-related distress, according to a Cochrane review of 30 randomized controlled trials involving nearly 9,200 individuals. However, the interventions did provide some benefit for self-efficacy and small improvement in HbA1c levels. Interventions in the trials ranged between 1 and 12 months and mostly occurred in community settings. Among the findings (all based on low-quality evidence):

• Psychological interventions had a small positive effect on confidence for self-care and HbA1c levels.
• They had no firm effect on diabetes-related distress, health-related quality of life, death from any cause, adverse events, or blood pressure levels.
• There was no evaluation of diabetes-related complications or socioeconomic effects.