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

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.