Factors related to stress in patients with non-insulin-dependent diabetes mellitus.

Stress was assessed using State-Trait Anxiety Inventory scores in 40 non-insulin-dependent diabetes mellitus (NIDDM) patients, and the results were compared with those for 40 sex- and age-matched healthy controls. Fludiazepam was administered to the patients for 12 weeks and stress was reassessed. The Manifest Anxiety Scale score correlated with Trait (r = 0.548, P < 0.0001) and State (r = 0.474, P = 0.0001) scores, validating the latter as measurements of stress. Both Trait (43.4 vs 35.8, P < 0.001) and State (41.6 vs 33.8, P < 0.001) scores were significantly higher in NIDDM patients than in healthy controls. Administration of an anxiolytic, fludiazepam (0.25 mg, three times daily, orally) for 12 weeks lowered Trait score (43.5 to 36.9, P < 0.0001), State score (41.6 to 35.8, P < 0.0002), glycosylated haemoglobin (8.4 to 7.3%, P < 0.0001), systolic blood pressure (151.2 to 143.4 mmHg, P < 0.0017) and diastolic blood pressure (84.2 to 77.7 mmHg, P < 0.0018). Multiple regression analysis revealed that the significant explanatory variables for the change in State score during anxiolytic administration were the changes in total cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein B:A1 and glycosylated haemoglobin (R2 = 0.3224, P < 0.0022). The results indicate that stress is detected at a higher frequency in patients with NIDDM than in healthy controls, and that blood glucose and lipid metabolic factors are significant explanatory variables for this stress. This stress is correlated with glucose metabolism and blood pressure and, moreover, these factors could all be proved concomitantly by the administration of an anxiolytic.