Challenge thoughts to treat diabetic pain

BOSTON U. (US) — A type of psychological therapy that focuses on changing negative thoughts and behaviors can help relieve pain for people with painful diabetic neuropathies, research shows.

Published in the Journal of Pain, a new study is the first to examine cognitive behavioral therapy (CBT) as treatment for people with type II diabetes mellitus, the most common form of the disease that affects more than 20 million people in the US.

The onset of type II diabetes mellitus is often gradual, occurring when a person is unable to make or use insulin efficiently. As a result, abnormally high levels of sugar accumulate in the blood, resulting in a condition called hyperglycemia.


Untreated hyperglycemia can develop into diabetic neuropathies, or nerve damage, which causes painful burning and stinging sensations in the hands and feet and permanent nerve damage. Although pain medications for this condition exist, they often have negative side effects such as headaches, dizziness, and nausea.

Researchers assessed whether CBT, a psychological treatment approach aimed at changing maladaptive thoughts and illness-supporting behaviors, could be of benefit to veterans with painful diabetic neuropathies.

The study, which was conducted at the VA Boston Healthcare System, compared participants receiving CBT to those receiving treatment as usual. Participants were US veterans 18 and older who had been diagnosed with type II diabetes and experienced neuropathic pain for more than three months.

Participants attended 11, hour-long CBT sessions, which focused on teaching participants relaxation techniques and how to identify and challenge thoughts that contribute to pain. In addition, participants were taught how to keep active and plan enjoyable activities such as exercise, going for walks, or having dinner with friends.

At a four-month follow-up, participants who received CBT reported feeling less pain and reported that pain interfered less with their daily lives when compared to participants who received standard treatment.

“This study demonstrates that the millions of people who are experiencing pain and discomfort from type II diabetes mellitus do not need to rely solely on medication for relief,” says John D. Otis, associate professor of psychiatry at Boston University School of Medicine.

“More broadly, the results of this study add to a growing body of literature demonstrating that cognitive behavioral therapy is an effective psychological treatment approach for chronic pain management.”

This work was supported by a grant from the Veterans of Foreign Wars to the diabetes research program at VA BHS.

Source: Boston University