Psychological moderator variables and metabolic control in recent onset type 1 diabetic patients--a two year longitudinal study.
The relationships between psychosocial adjustment and subsequent glycaemic control were prospectively examined in forty-three adult patients during the first 2 yr after onset of type 1 diabetes mellitus. Decreasing depression was the single psychosocial parameter that changed over time. No correlations were found between the decrease in HbA1c levels and psychological variables at 8- and 16-month follow-ups. Global and specific coping features such as high control attitude, low coping anxiety and low emotional attribution correlated significantly with the decrease in HbA1c levels at the 2-yr follow-up, whereas stressful life events, depression, state-trait anxiety did not correlate. In a regression analysis coping explained 22% variance of the 2 yr decrease in HbA1c levels. We conclude that coping is a better predictor for metabolic control than emotional adaptation and life events. Metabolic control might deteriorate with prolonged stage of the disease being a first sign for psychophysiological coping exhaustion.
Institute of Medical Psychology, Vienna University, Austria.
K
K
Spiess
G
G
Sachs
G
G
Moser
P
P
Pietschmann
G
G
Schernthaner
R
R
Prager
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology; D001786:Blood Glucose / Q000032:analysis*; D003430:Cross-Sectional Studies; D003717:Denial, Psychological; D003866:Depressive Disorder / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
D001786:Blood Glucose; D006442:Glycated Hemoglobin