Stress Management Improves Long-Term Glycemic Control in Type 2 Diabetes

Surwit, Richard S.; Tilburg, Miranda A.L. van; Zucker, Nancy; McCaskill, Cynthia C.; Parekh, Priti I.; Feinglos, Mark N.; Edwards, Christopher L.; Williams, Paula; Lane, James D.

doi:10.2337/diacare.25.1.30

Cited by 290 publications

(215 citation statements)

References 20 publications

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“…Elevated stress, in turn, could speed rates of BGL decrease, so this seemed a plausible alternative explanation (20). Participants, however, reported no difference in perceived stress levels across conditions.…”

Section: Discussionmentioning

confidence: 90%

Blood sugar level follows perceived time rather than actual time in people with type 2 diabetes

Chanmo

Pagnini

Reece

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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The current study investigates whether perceived time has an effect on blood glucose level in people with type 2 diabetes. The hypothesis is that perceived time will have a greater influence over blood glucose level than actual time. Changes in blood glucose levels were measured in 46 participants with diabetes while they completed simple tasks during a 90-min period. Participants' perception of time was manipulated by having them refer to clocks that were either accurate or altered to run fast or slow. Blood glucose levels changed in accordance with how much time they believed had passed instead of how much time had actually passed. These results are an example of the influence psychological processes can directly exert on the body. T he relationship between expectations and physiological responses has received much attention in the study of the placebo effect (1, 2), a phenomenon producing physiological changes in the body without specific biological stimulation (3). For example, the expectation that an activity leads to a decrease in weight may result in an actual reduction of weight (4), and perceptions also change physiological responses to food consumption (5). Similarly, study participants role-playing air force pilots, a group expected to have excellent vision, had better vision than control participants (6). Despite a broad range of data describing the influence of mental states over the body, the role of psychological processes, especially when dealing with chronic health conditions, has been frequently underestimated. The connection between mind and body has received particularly limited attention in the study of metabolic disorders, such as diabetes.Type 2 diabetes, the most common form of diabetes, is a chronic disease that affects millions (7). Its symptoms include periodic rises in blood glucose levels (BGLs) because the body produces insufficient insulin and/or resists the effects of insulin, leading to short-term severe shock and multiple long-term complications including strokes, neuropathies, kidney disease, and vision problems (8). Genetic factors appear to be a strong biological trigger (9), and obesity seems to be a powerful environmental trigger (10).Although recognized as relevant psychosocial elements in diabetes management, few psychological factors have been studied for the effect they can exert on diabetic physiology. The majority of studies concerning psychological issues and diabetes have focused on depression, a serious comorbid condition (11), or on the negative effect of distress on disease management (12). Apart from studies on depression and distress, limited efforts have been made to investigate the effect of psychological variables on blood sugar regulation. No studies to our knowledge have investigated the potential for psychological mechanisms to directly influence BGLs.Glucose levels in people with type 2 diabetes follow a particular time course, but how is the course determined? Current models suggest it is determined solely by physiological factors (13). There is, howeve...

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Section: Discussionmentioning

confidence: 90%

Blood sugar level follows perceived time rather than actual time in people with type 2 diabetes

Chanmo

Pagnini

Reece

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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“…Tais estudos sugerem que esses indivíduos, ao serem expostos a situações aversivas, apresentariam dificuldades no manejo da doença comprometendo a adesão ao tratamento e consequentemente a sua qualidade de vida. No caso específico do diabetes, estudos sugerem haver correlação positiva entre esses fatores e o curso da doença [8][9][10][11] .…”

Section: Fatores Emocionais No Manejo Do Diabetesunclassified

Fatores emocionais, qualidade de vida e adesão ao tratamento em adultos com diabetes tipo 2

Ramos

Ferreira

2011

J. Hum. Growth Dev.

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Adesão ao tratamento em adultos com diabetes tipo 2Rev Bras Crescimento Desenvolvimento Hum. 2011; 21( ABSTRACTThis study has the purpose of verifying the relationship between emotional factors (stress, anxiety and depression) life quality and adherence to the treatment in adults suffering from type 2 diabetes. Thirty people (18 women and 12 men aging from 33 to 59) participated in the study. All enrolled in the Hiperdia program of a municipal health unit. Instruments used were the inventories of anxiety and Beck's depression, Lipp's inventory of Stress Symptoms The adherence to the treatment was measured by means of the latest result of glycated hemoglobin exam. The results showed that there was no relation between emotional factors and adherence to the treatment. However it was verified a significant correlation between diabetes diagnosis time and adherence, thus suggesting that the longer the time the participant presented the illness, the bigger the difficulty in maintaining the glucose levels stabilized and adhering to the prescribed orientations. It was also observed the positive correlation between low adherence and family structure, predominantly nuclear. The results suggest that other factors besides the emotional ones must be considered in the analysis of adherence to treatment.

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“…There has also been a critical underrepresentation of Black men in research investigations examining the effectiveness of interventions aimed at t2dm prevention and management (Wessells, 2010). Although some interventions have helped individuals to enhance their selfcare behaviors and better manage their t2dm (McGinnis, McGrady, Cox, & Grower-Dowling, 2005;Norris, Engelgau, & Narayan, 2001;Surwit et al, 2002), much of the published work on t2dm, including the nationally recognized Diabetes Prevention Program (DPP), have observed poorer outcomes among Blacks (DPP Research Group, 2004) and lower levels of participation among Black men specifically (Davis-Smith, 2007;Dodani & Fields, 2010;West, Prewitt, Bursac, & Felix, 2008). The reasons for the lack of participation by Black men with t2dm are not well described in the literature.…”

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confidence: 99%

The Influence of Stress, Gender, and Culture on Type 2 Diabetes Prevention and Management Among Black Men

2015

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This study used focus-group methodology to seek understanding about the unique influence of stress, gender, and culture on type 2 diabetes mellitus (t2dm) prevention and management among Black men. Twenty men from Iowa were recruited from a larger longitudinal study on Black families; each of these men participated in one of three focus groups. Ninety-five percent of the men in the sample were Black and all were either diagnosed with t2dm ( n = 10), were prediabetic ( n = 1), or had experience with t2dm through family and friends ( n = 9). Our results revealed the existence of significant stress and some pessimism with respect to perceived ability to prevent and manage t2dm. The participants made it clear that, while their families are primary sources of support for managing stress, including t2dm, they can also be a source of stress, particularly with respect to parenting. Black men had mixed opinions on their relationships with respect to their health care providers; some had positive, long-standing relationships while others reported little or no relationship with their providers. In response to life stress, Black men reported experiencing inadequate and disrupted sleep as well as consuming too much alcohol at times. Some of the participants reported engaging in physical activity to manage their stress. The study concluded that, as researchers develop t2dm prevention and management programs, they should continue to consider the unique role that stress in its various forms, plays in the lives of Black men.

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Stress Management Improves Long-Term Glycemic Control in Type 2 Diabetes

Cited by 290 publications

References 20 publications

Blood sugar level follows perceived time rather than actual time in people with type 2 diabetes

Blood sugar level follows perceived time rather than actual time in people with type 2 diabetes

Fatores emocionais, qualidade de vida e adesão ao tratamento em adultos com diabetes tipo 2

The Influence of Stress, Gender, and Culture on Type 2 Diabetes Prevention and Management Among Black Men

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