A longitudinal study of coping, anxiety and glycemic control in adults with type 1 diabetes

Abstract

Diabetes is a unique disorder in how much it requires a high degree of individual self management strategies. Anxiety and stress can affect glycemic control, and thus management of emotions may be key to good glycemic control. This study is the first to examine how anxiety and coping style, and their interaction, can affect long-term glycemic control. We measured anxiety, coping, and HbA1C, a measure for mean blood glucose levels in the previous 6-8 weeks, in 115 patients with Type 1 diabetes at baseline and roughly 5 years later. We found that coping predicted outcomes, especially for those high in trait anxiety. Trait anxiety predicted limited increases in HbA1C (mean increase = 0.02%). Lower levels of emotion-oriented coping predicted clinically significant increases in HbA1C, but only for those high on baseline trait anxiety (mean increase = 0.92%). Task-oriented coping predicted decreases in state anxiety. Use of task- and emotion-oriented coping appears especially important for highly anxious patients, both for emotional regulation and glycemic control. So, coping styles, basal anxiety and their interactions should be considered in designing follow-up and interventions with diabetic patients.

Coping style and depression influence the healing of diabetic foot ulcers: observational and mechanistic evidence

“…The assessment of coping styles, in addition to distress, was conducted because of their central role in the human stress process, and specifically their influence on the individual's emotional reactions to demanding/stressful experiences, including disease [13]. Indeed, in diabetes, the interaction between coping style and psychological distress has been shown to influence glycaemic control [14][15][16]. Our secondary aims included: (1) an examination of the effects of distress and coping style on an additional healing outcome, i.e.…”

Gender differences in the relationship between parental report of self-regulation skills and adolescents' management of type 1 diabetes

“…Better coping with these affective and stressful aspects of diabetes treatment will likely result in better behavioral adherence to the treatment regimen and subsequently better glycemic control. Support for this link has been found in the adult literature as a recent study found that a coping style that promoted better emotion regulation was associated with better glycemic control (25). However, to date, no study has examined the extent to which adolescents' emotion regulation skills relate to treatment adherence and glycemic control.…”

Incorporating Psychological Predictors of Treatment Response into Health Economic Simulation Models

“…The psychological prediction models tested had moderate predictive power of HbA 1c response to DAFNE, and this may have been limited because some of the predictors of DAFNE response were not collected or are not observable. Other variables such as personality factors 25,36 or attitudes toward the DAFNE course 37 could have provided additional predictive power to the regression models. Combining more detailed information from future psychological questionnaire data collected from DAFNE graduates with published qualitative findings [38][39][40] would allow the psychological prediction models to be refined.…”