Tele–Cognitive Behavioral Therapy for the Treatment of Diabetes-Related Distress in Individuals With Diabetes Mellitus: Systematic Review and Meta-Analysis of Randomized Controlled Trials

This systematic review is the first to quantify the disease-specific efficacy of Tele-CBT for improving DD, depressive symptoms, and HbA1c in people with diabetes, demonstrating its value as an accessible alternative to in-person therapy. By addressing diabetes-specific psychological needs and overcoming practical barriers through remote delivery, Tele-CBT offers a scalable solution for underserved populations. These findings require cautious interpretation due to substantial heterogeneity, moderate risk of bias, and low certainty of evidence. The 95% PIs indicate that real-world benefits may vary considerably by setting or population. Nevertheless, Tele-CBT represents a promising, cost-effective approach to expanding mental health care access. Given its likely variable effectiveness, more evidence is required to determine its value across diverse health care settings.