Cutting stress helps diabetics control blood sugar

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Cutting stress helps diabetics control blood sugar

By Suzanne Rostler

NEW YORK, Dec 27 (Reuters Health) - Programs that help people with

diabetes to manage stress can help lower blood sugar levels and may

eventually reduce the risk of medical complications such as kidney

disease and blindness, according to a study released Thursday.

The report of 72 adults with type 2 diabetes found that those who

participated in just 5 sessions of group stress management therapy

reduced their long-term blood sugar (glucose) by an average of

0.5%--equal to the effect seen with some drugs. Nearly one third of

patients who received stress management lowered their blood glucose

levels by 1%, compared with 12% of diabetics who did not participate in

the sessions.

According to the authors, reducing blood glucose by as little as 0.5%

may translate into a lower risk of diabetes-related medical

complications. Earlier studies had shown that intensive, one-on-one

stress management sessions can help diabetics to control their blood

sugar, and this study is the first to show that a group approach can

work as well, according to the report.

" Patients with type 2 diabetes should be aware that stress can

negatively impact on glucose control. They might want to try learning

stress management either in a clinical setting or through a self-help

approach, " Dr. Surwit, the study's lead author, told Reuters

Health.

The results are published in the January issue of Diabetes Care.

The study included patients at least 30 years old who managed their

diabetes through a combination of diet, exercise and oral medication.

Individuals who were receiving therapy and those who had participated in

other previous relaxation or stress management training were excluded.

The 38 patients in the stress management program learned muscle

relaxation techniques and ways to recognize and reduce stress through

deep breathing or guided imagery. Instructors encouraged participants to

practice the techniques on their own at home and talked about the health

consequences of stress.

As a " control " group, 34 patients received general diabetes education,

including information about symptoms, complications, nutrition and

treatment.

After 1 year, patients who received stress management had lower glucose

levels while those in the control group showed slightly higher blood

glucose levels, report researchers. Their study found no significant

changes in diet and exercise habits, suggesting that these lifestyle

factors did not contribute to the lower blood sugar levels seen in

adults participating in stress management sessions.

Patients who were the most anxious before the study began did not

benefit any more than those who were only mildly stressed, the study

found.

" This study...suggests that stress management can be a meaningful

addition to a comprehensive treatment program for patients with type 2

diabetes, " concludes the team of researchers from Duke University in

Durham, North Carolina.

Surwit said that future studies should examine whether audio or

videotapes are an effective way of learning stress management.

" Given the cost-consciousness of American health care, even a relatively

inexpensive group therapy approach might be considered too costly.

However, if one compares the cost of our intervention with that of a

year's worth of some medication which might be added to what a patient

is currently taking, I believe that our approach would be less

expensive, " he said.

SOURCE: Diabetes Care 2002;25:30-34.