Last updated August 24, 2026
Key finding
Mean difference (MD) -5.83; 98.75% CI -11.26 to -0.41
This study compared a guided self-determination intervention to an attention control in adults with type 2 diabetes, finding significant reductions in diabetes distress and depressive symptoms.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Long-Term (1–5 y)
Risk of bias
High Risk
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study compared a guided self-determination intervention to an attention control in adults with type 2 diabetes, finding significant reductions in diabetes distress and depressive symptoms.
These findings highlight the potential of guided self-determination interventions in managing psychological aspects of diabetes, which can lead to better overall health outcomes. Addressing diabetes distress and depressive symptoms is crucial for improving patients' quality of life and adherence to diabetes management.
Limited generalizability due to specific population characteristics. No significant changes observed in HbA1c or motivation. Potential biases in self-reported outcomes.
Published in
Publication details and source links for this paper.
Anne SM, Vibeke Z, Jane L, et al. Guided self-determination intervention versus attention control in adults with type 2 diabetes: a randomized controlled trial. BMJ Open. 2026;16(6):e111164. doi:10.1136/bmjopen-2025-111164
Diabetes distress significantly reduced by 5.83 points (p=0.007).
Depressive symptoms significantly reduced by 2.77 points (p=0.005).
Mental quality of life improved by 8.10 points (p=0.005).
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Guided self-determination (GSD) and Adverse events incidence, Depression score, Diabetes distress scores, and 3 more.
This study contributes evidence to
Primary intervention
Guided self-determination (GSD)
Primary outcomes
Evidence topics
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
1
Related topics
6
Evidence pairs
449
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Evidence topic
Contributes evidence
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Primary evidence
Evidence topic
matched_outcome
Core evidence
The primary outcomes reported in this study.
Guided self-determination (GSD) → Adverse events incidence
Guided self-determination (GSD) → Adverse events incidence
Guided self-determination (GSD) → Depression score
Guided self-determination (GSD) → Depression score
Guided self-determination (GSD) → Diabetes distress scores
Guided self-determination (GSD) → Diabetes distress scores
Guided self-determination (GSD) → Quality of life
Guided self-determination (GSD) → Quality of life
Guided self-determination (GSD) → Quality of life (physical component)
Guided self-determination (GSD) → Quality of life (physical component)
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Guided self-determination (GSD) and Adverse events incidence, Guided self-determination (GSD) and Mental Health.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Behavioral & Lifestyle
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies measuring Adverse events incidence
Measures Adverse events incidence as a key outcome.
All studies on Guided self-determination (GSD)
Contributes to Guided self-determination (GSD) evidence base.
All studies measuring Mental Health
Measures Mental Health as a key outcome.
All studies measuring Quality of Life Outcomes
Measures Quality of Life Outcomes as a key outcome.
Latest published studies
Published within the last 2 years.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Guided self-determination (GSD) appears to improve Depression score.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Depression score
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Guided self-determination (GSD) appears to improve Diabetes distress scores.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Diabetes distress scores
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Guided self-determination (GSD) appears to improve Quality of life.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Quality of life
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Guided self-determination (GSD) for Adverse events incidence.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Adverse events incidence
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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