title: Daily stress and glycaemic control in Type 1 diabetes: individual differences in magnitude, direction, and timing of stress-reactivity.
abstract: The aim of this study was to investigate the relationships between daily stress and glycaemic control in 54 people with Type 1 diabetes over 21 days. Measures included daily reports of stress (hassles), four-times-daily blood glucose measurements, and HbA1c levels. Time-series analyses revealed considerable variation between individuals in the nature and extent of blood glucose response to stress (stress-reactivity). In approximately one-third of the sample, stress was significantly associated with either same- or next-day blood glucose levels (r-range: -0.79 to 0.58). The majority of stress-reactive individuals (20.4% of the sample) demonstrated a positive association between hassles and same-day blood glucose levels. A much less common effect was found in two individuals (3.7%), where hassles were related to decreased same-day blood glucose. 'Stress-reactive' individuals tended to have high HbA1c values at baseline (t(52) = 2.2; P < 0.05), and significant relationships between emotion-focused coping and blood glucose levels (r = 0.93; P < 0.01). In conclusion, although a significant majority of this sample was resistant to the effects of stress, marked individual differences were found in the nature and extent of stress-reactivity. Our study goes beyond other published results as it is longitudinal, uses time-series analyses and includes a relatively larger sample. Clinicians need to be aware of these individual differences in order to advise patients about anticipating and preventing stress-related disruptions of glycaemic control.
authors.affiliation: Department of Psychology, Royal Holloway, University of London, Surrey, UK. afsane.riazi@brunel.ac.uk
authors.forename: Afsane
authors.initials: A
authors.lastname: Riazi
authors.forename: John
authors.initials: J
authors.lastname: Pickup
authors.forename: Clare
authors.initials: C
authors.lastname: Bradley
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications*; D005260:Female; D006801:Humans; D007206:Individuality; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology*
chemical_list: D001786:Blood Glucose