Methodologically, we will conduct a randomized controlled trial involving T2DM patients aged 18-65 years. Participants will be randomly assigned to either the intervention group or the control group. The intervention group will receive six sessions of CBT administered by trained therapists over a period of one month, while the control group will receive standard diabetes care without CBT intervention.

Outcome measures will include perceived stress levels assessed using the Perceived Stress Scale (PSS-10), depression and anxiety symptoms measured using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales, respectively, self-worth assessed using the Rosenberg Self-Esteem (RSE) scale, gratitude practices measured using the Gratitude Questionnaire-6 (GQ-6), and glycemic control evaluated through Hemoglobin A1c (HbA1c) levels.

Additionally, demographic data and information on diabetes-related factors such as duration of diagnosis, medication adherence, and lifestyle habits will be collected through structured interviews and medical records review.

The study will be conducted in a real-world clinical setting to enhance the generalizability of findings. Ethical approval is obtained, and informed consent is obtained from all participants before enrollment. Data analysis will be performed using appropriate statistical methods to compare outcomes between the intervention and control groups, with significance set at p < 0.05.

Overall, the study design and methodology ensure rigorous evaluation of the effectiveness of CBT in managing stress and improving glycemic control among T2DM patients in India, with potential implications for enhancing diabetes care globally.