Comparison of the Effects of Group Reality Therapy and Group Dialectical Behavior Therapy on Fasting Blood Sugar, 2hpp, and Hemoglobin A1c in Women with Type 2 Diabetes

Abstract

Background: Numerous studies have examined the effectiveness of reality therapy and dialectical behavior therapy (DBT). However, direct comparisons of these approaches regarding their impact on fasting blood sugar (FBS), two-hour postprandial blood glucose (2hpp), and hemoglobin A1c (HbA1C) in women with type 2 diabetes are lacking. Objectives: The present study aimed to compare the effectiveness of reality therapy and DBT on FBS, 2hpp, and HbA1C in women with type 2 diabetes. Methods: This semi-experimental study utilized a pre-test, post-test, and two-month follow-up design with a control group. The statistical population consisted of all women with type 2 diabetes attending a specialized diabetes clinic in Shiraz in 2024. A total of 45 participants (15 in the reality therapy group, 15 in the DBT group, and 15 in the control group) were selected after applying inclusion and exclusion criteria and were randomly assigned to the three groups. The first experimental group received DBT based on Linehan's protocol (2015), and the second group received reality therapy based on E. Wubbolding's perspective (2013), both in 12 sessions of 90 minutes each. The control group received no intervention. Data were analyzed using descriptive statistics [mean ± standard deviation (SD)] and analysis of variance (ANOVA). Results: The mean ± SD FBS values in the DBT group at pre-test, post-test, and follow-up were 140.06 ± 15.72, 117.06 ± 14.39, and 120.93 ± 18.07, respectively. In the reality therapy group, these values were 134.26 ± 23.23, 116.33 ± 23.66, and 119.93 ± 21.53, respectively. For the 2hpp variable, the DBT group had values of 155.52 ± 23.28, 131.00 ± 21.25, and 131.13 ± 18.41; the reality therapy group had 145.26 ± 22.18, 112.40 ± 23.38, and 114.80 ± 23.71. For HbA1C, the DBT group reported 7.0 ± 0.55, 6.23 ± 0.61, and 6.34 ± 0.69, while the reality therapy group had 6.9 ± 0.76, 6.42 ± 0.70, and 6.35 ± 0.73. Both intervention methods significantly reduced FBS, 2hpp, and HbA1C at post-test and follow-up (P < 0.001). A significant difference was observed between the experimental groups and the control group (P < 0.001). However, the difference between the DBT and reality therapy groups was not significant at either post-test or follow-up (P > 0.05). Conclusions: Both reality therapy and DBT are effective interventions for reducing blood sugar levels in women with type 2 diabetes.