OBJECTIVE To determine whether a mindfulness-based stress reduction (MBSR) intervention is effective for reducing psychosocial distress (i.e., depression, psychosocial stress) and the progression of nephropathy (i.e., albuminuria) and for improving the subjective health status of patients with type 2 diabetes.RESEARCH DESIGN AND METHODS Patients with type 2 diabetes and microalbuminuria were randomized to a mindfulness-based intervention (n = 53) or a treatment-as-usual control (n = 57) group. The study is designed to investigate long-term outcomes over a period of 5 years. We present data up to the first year of follow-up (FU). RESULTS At FU, the MBSR group showed lower levels of depression (d = 0.71) and improved health status (d = 0.54) compared with the control group. No significant differences in albuminuria were found. Per-protocol analysis also showed higher stress reduction in the intervention group (d = 0.64). CONCLUSIONS MBSR intervention achieved a prolonged reduction in psychosocial distress. The effects on albuminuria will be followed up further. Several studies reported not only an increased incidence of depression among patients with type 2 diabetes (1), but also a putative causal role of psychological distress in the pathogenesis of diabetes (2) and its complications (3,4). As shown by our research group, psychological stress is linked to the activation of proinflammatory transcription factors known to be involved in late diabetes complications (5,6). Because previous studies in diabetes and other medical diseases indicate that mindfulness-based stress reduction (MBSR) or an MBSR component may be effective in reducing or preventing depression and stress as well as increasing health status (7–10), we initiated a 5-year trial with albuminuria progression as the primary end point and psychological distress, health status, mortality, cardiovascular events, and the activation of proinflammatory transcription factors as secondary end points.