title: Impact of psychological stress caused by the Great East Japan Earthquake on glycemic control in patients with diabetes.
abstract: We examined the relationship between psychological stress and the worsening of glycemic control in diabetic patients at the time of the Great East Japan Earthquake. HbA1c levels in diabetic patients before and after the disaster were evaluated with the General Health Questionnaire (GHQ) and other questions including those on changes in diet, exercise, psychological stress and drug intake in 320 consecutive diabetic patients who had been followed in a diabetes clinic. Logistic regression analysis revealed that the total GHQ scores (odds ratio [OR] 1.03 [95% confidence interval 1.01-1.06]; p<0.01) and interruption of drug intake (OR 4.48 [1.57-12.7]; p=0.01) were independently associated with worsening of glycemic control defined as an increase in the HbA1c level equal to or greater than 0.5%. Among the scores on the GHQ, those for somatic symptoms (OR 1.18 [1.01-1.38]; p=0.03) and sleep disturbances or anxiety (OR 1.26 [1.08-1.46]; p<0.01) were independently associated with glycemic control. These results suggest that psychological stress during a disaster has independent effects on worsening of glycemic control.
authors.affiliation: Department of Endocrinology and Metabolism, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Fujihara
authors.forename: A
authors.initials: A
authors.lastname: Saito
authors.forename: Y
authors.initials: Y
authors.lastname: Heianza
authors.forename: H
authors.initials: H
authors.lastname: Gibo
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: H
authors.initials: H
authors.lastname: Shimano
authors.forename: K
authors.initials: K
authors.lastname: Saito
authors.forename: S
authors.initials: S
authors.lastname: Kodama
authors.forename: N
authors.initials: N
authors.lastname: Yamada
authors.forename: H
authors.initials: H
authors.lastname: Sone
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D055866:Earthquakes; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000453:epidemiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000600:supply & distribution / Q000627:therapeutic use; D007564:Japan / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D012892:Sleep Deprivation / Q000453:epidemiology / Q000209:etiology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology; D013315:Stress, Psychological / Q000209:etiology* / Q000503:physiopathology*
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human