R Vasanth1, Aparna Ganesh, R Shanker. 1. Department of Psychiatry, Sri Muthukumaran Medical College, Hospital and Research Institute, Chennai, India.
Abstract
BACKGROUND: Type 2 diabetes mellitus (T2DM) is one among the major health and socioeconomic problems worldwide. It is, however, not a somatic illness for which just symptomatic treatment will suffice. Stress is an important factor in not only causing diabetes onset or exacerbation, but also in hampering proper treatment by interfering with the treatment adherence of patients. Hence, it becomes important for physicians to acquaint themselves with the effects of stress on T2DM in order to ensure proper treatment of the latter. OBJECTIVE: Documentation of effect of stress on the management of T2DM. SUBJECTS AND METHODS: The research was a cross-sectional study on the patients attending Sri Muthukumaran Medical College, Hospital and Research Institute, Mangadu. A total of 400 people, who werepre-established diabetic patients of the hospital of age greater than 30 years, were chosen for the study. The stress levels of the patients were assessed with the Perceived Stress Scale (PSS) and treatment adherence using a questionnaire prepared exclusively for the study. Based on the data, a statistical relationship was framed between the degree of control (treatment adherence) and the stress levels of the patients. RESULTS: The FBS levels were a direct reflection of the stress levels (P<0.05). Stress had a major impact on treatment adherence among the diabetic subjects: Increased levels of stress decreased the adherence (P<0.001). The glycemic index (HbA1C level) was found to be linked to both treatment adherence and stress. Increased adherence kept it at bay (P<0.05) while stress proved abysmal to glycemic control. CONCLUSION: T2DM is the result of an interplay between various factors; environmental, psychiatric and somatic. Hence, a holistic treatment approach is required, one that involves stress management, education and mental health awareness along with pharmacological treatment, to fully control the disease.
BACKGROUND:Type 2 diabetes mellitus (T2DM) is one among the major health and socioeconomic problems worldwide. It is, however, not a somatic illness for which just symptomatic treatment will suffice. Stress is an important factor in not only causing diabetes onset or exacerbation, but also in hampering proper treatment by interfering with the treatment adherence of patients. Hence, it becomes important for physicians to acquaint themselves with the effects of stress on T2DM in order to ensure proper treatment of the latter. OBJECTIVE: Documentation of effect of stress on the management of T2DM. SUBJECTS AND METHODS: The research was a cross-sectional study on the patients attending Sri Muthukumaran Medical College, Hospital and Research Institute, Mangadu. A total of 400 people, who werepre-established diabeticpatients of the hospital of age greater than 30 years, were chosen for the study. The stress levels of the patients were assessed with the Perceived Stress Scale (PSS) and treatment adherence using a questionnaire prepared exclusively for the study. Based on the data, a statistical relationship was framed between the degree of control (treatment adherence) and the stress levels of the patients. RESULTS: The FBS levels were a direct reflection of the stress levels (P<0.05). Stress had a major impact on treatment adherence among the diabetic subjects: Increased levels of stress decreased the adherence (P<0.001). The glycemic index (HbA1C level) was found to be linked to both treatment adherence and stress. Increased adherence kept it at bay (P<0.05) while stress proved abysmal to glycemic control. CONCLUSION: T2DM is the result of an interplay between various factors; environmental, psychiatric and somatic. Hence, a holistic treatment approach is required, one that involves stress management, education and mental health awareness along with pharmacological treatment, to fully control the disease.