Stress Resilience Among Patients with Type 2 Diabetes

The present study evaluated the impact of a multicomponent diabetes management program integrating psychoeducation, mindfulness, and biofeedback on physiological stress resilience in patients with type 2 diabetes mellitus (T2DM). A quasi-experimental pre\u2013post design was used with 24 participants (mean age = 56 \u00b1 10.2 years) receiving care at a diabetes clinic in Mexico City. The intervention included psychoeducation on diabetes and stress, mindfulness training with information and recordings for daily mindfulness meditation practice, and two individual mindfulness-assisted heart-rate variability (HRV) biofeedback sessions. Physiological responses to stress were quantified through the Stress Resilience Index (RSI), calculated from changes in psychophysiological signals during stress and recovery phases in a pre designed Psychophysiological Stress Profile test. Both, biofeedback training and measurements for changes in psychophysiological signales included the use of snesors for galvanic skin response (GSR), respiration, and blood volume pulse (BVP) recorded and encoded through a ProComp5 Infiniti system. Post-intervention analyses showed a significant increase in mean RSI from 0.016 (SD = 0.057) to 0.064 (SD = 0.075), p = 0.009, Cohen's d = 0.587, with 71\\% of participants with improved resilience to stress. These findings indicate that integrating psychoeducation, mindfulness, and biofeedback can enhance autonomic flexibility and physiological recovery from stressors in individuals with T2DM. The results support the incorporation of psychophysiological self-regulation training into diabetes care as a cost-effective strategy to reduce stress-related glycemic vulnerability and improve patient self-management.