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OBJECTIVE -There is conflicting evidence regarding the utility of stress management training in the treatment of diabetes. The few studies that have shown a therapeutic effect of stress management have used time-intensive individual therapy. Unfortunately, widespread use of such interventions is not practical. The aim of the present investigation is to determine whether a cost-effective, group-based stress management training program can improve glucose metabolism in patients with type 2 diabetes and to determine whether a particular subset of patients is more likely to get positive results.RESEARCH DESIGN AND METHODS -Patients with type 2 diabetes were randomized to undergo a five-session group diabetes education program with or without stress management training. Participants (n ϭ 108) were followed for 1 year, during which HbA 1c tests and questionnaires assessing perceived stress, anxiety, and psychological health were administered at regular intervals to evaluate treatment effects.RESULTS -Stress management training was associated with a small (0.5%) but significant reduction in HbA 1c . Compliance with the treatment regimen decreased over time but was similar to that seen in patients receiving stress management for other reasons in the clinic. Trait anxiety (a measure of stable individual differences in anxiety proneness) did not predict response to treatment, showing that highly anxious patients did not derive more benefit from training. CONCLUSIONS -The current results indicate that a cost-effective, group stress management program in a "real-world" setting can result in clinically significant benefits for patients with type 2 diabetes.

Abbreviations: NEO-PI-R, NEO Personality Inventory, Revised; SMBG, self-monitoring of blood glucose. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Personality Correlates of Glycemic Control in Type 2 Diabetes O R I G I N A L A R T I C L EOBJECTIVE -To determine whether traits of normal personality are associated with variations in glycemic control in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS -A longitudinal cohort study was conducted using data from 105 type 2 diabetic patients in a clinical trial of a stress management intervention. Before treatment assignment, patients completed the NEO Personality Inventory, Revised, which is a questionnaire inventory measuring 5 major domains of normal personality and 30 important traits that define these domains. Glycemic control was assessed by measures of HbA 1c and average blood glucose levels based on 7 days of self-monitoring at baseline and at 6 and 12 months. Relationships between personality traits and measures of glycemic control were examined by correlation and linear regression models that were adjusted for age, sex, race, duration of diabetes, medication status, and experimental treatment.RESULTS -Lower average blood glucose values at baseline were associated with higher scores for the personality domain of neuroticism and several specific traits including anxiety, angry hostility, depression, self-consciousness, and vulnerability but were associated with lower scores for the trait of altruism. Results were similar for HbA 1c but were not as strong. Followup results were similar but were less consistent.CONCLUSIONS -Personality traits may offer new insights into variations in glycemic control in patients with type 2 diabetes undergoing standard management. The relative tendency to experience fewer negative emotions and to focus on the needs of others instead of oneself could prove to be a risk factor for poor glycemic control.