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The mediating role of mindfulness in the relationship between alexithymia and glycemic control in patients diagnosed with type 2 diabetes mellitus
1Trabzon University, Faculty of Medicine, Department of Psychiatry, Trabzon, Turkiye
2Vakfıkebir State Hospital, Department of Internal Medicine, Trabzon, Turkiye
3Recep Tayyip Erdogan University, Faculty of Medicine, Department of Psychiatry, Rize, Turkiye
Dusunen Adam Journal of Psychiatry and Neurological Sciences 2025; 38(3): 169-179 DOI: 10.14744/DAJPNS.2025.00288
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Abstract

Objective: This study examines the impact of alexithymia and mindfulness on diabetes management, focusing on how their relationship affects glycemic control in patients with type 2 diabetes mellitus (T2DM). It evaluates the challenges posed by alexithymia in managing diabetes and the mediating role of mindfulness in this process.
Method: The study included 100 T2DM patients aged 18-65 who had been diagnosed for at least one year, alongside 100 healthy controls. Data were gathered through a sociodemographic form, the Toronto Alexithymia Scale (TAS-20), and the Mindful Attention Awareness Scale (MAAS). Glycemic control was assessed using hemoglobin A1c (HbA1c) levels.
Results: The prevalence of alexithymia in diabetic patients was 67%. Alexithymic individuals showed higher HbA1c levels and poorer blood sugar control (p<0.001). HbA1c levels were also significantly higher in those with lower mindfulness (p<0.001). A strong negative correlation was found between alexithymia and mindfulness (r=-0.789, p<0.001). TAS-20 scores significantly correlated with HbA1c (β=0.508, p<0.001), while higher MAAS scores were linked to better glycemic control (β=-0.674, p<0.001). When MAAS was included in the model, the direct relationship between TAS-20 and HbA1c lost significance (β=-0.024, p=0.85), indicating a mediating role of mindfulness.
Conclusion: Mindfulness was associated with better diabetes management and glycemic control and glycemic control in individuals with alexithymia symptoms. Incorporating mindfulness-based strategies into psychosocial interventions could enhance quality of life and treatment adherence for these patients, underscoring the need for a holistic approach to diabetes care.