Stress and Type 2 Diabetes.




Diabetes Care

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When blood sugar regulation is impaired, despite the availability of insulin, type 2 diabetes is suspected. Type 2 diabetes is characterized by elevated blood sugar and impaired insulin response. It is a non-ketotic form of diabetes. People with type 2 are not dependent on insulin to survive. The pathophysiology of type 2 diabetes is not fully understood. Three physiological abnormalities typically occur in type 2: insulin resistance, increased glucose production in the liver (hepatic gluconeogenesis), and poor beta cell function. These can occur individually or in combination.

The long-term complications associated with diabetes are serious, often life threatening, and diagnosed in the late stages of the disease. These complications are due to continuous hyperglycemia from poor glucose control. Many of these chronic complications can be traced to changes in blood vessels that cause a decreased blood flow. These changes include coronary heart disease and peripheral vascular disease, retinopathy, nephropathy, and neuropathy.

A few studies have been conducted to investigate the relationship between stress management and diabetes. However, these studies incorporated stress interventions that were not practical. A recent study published in the journal Diabetes Care, examined the role that stress management training has on glucose metabolism in patients with type 2 diabetes. For 1 year, this study followed 108 patients suffering from type 2 diabetes. At regular periods during the year, blood glucose levels were tested and the patients were asked to respond to questionnaires regarding stress, anxiety, and psychological health. The patients involved were randomized into 2 groups both of which received diabetes education. One group was offered instruction in stress management while the control group was not. A significant reduction in glucose levels was seen in the diabetic group who received the stress management training although patients who demonstrated unusually high levels of anxiety did not benefit from the training. The authors concluded that, "… a cost-effective, group stress management program in a "real-world" setting can result in clinically significant benefits for patients with type 2 diabetes."1


1. Surwit RS. Stress Management Improves Long-Term Glycemic Control in Type 2 Diabetes. Diabetes Care. Jan 2002;25:30-34.