Hormonal and blood glucose responsiveness as an indicator of specific emotional arousal in type 1 diabetics

Sachs, Gabriele; Spiess, Klaus; Moser, Gabriele; Kautzky, Alexander; Luger, Anton; Pietschmann, Péter; Schernthaner, G; Prager, R.

doi:10.1016/0022-3999(93)90172-c

Cited by 14 publications

(8 citation statements)

References 47 publications

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“…Examples are low levels of physical activity, functional restrictions due to diabetes or another medical condition, medical nonadherence, inadequate treatment secondary to poor appointment attendance, and the exacerbation of another medical condition. Underlying biological mechanisms have also been suggested, such that both depression and severe diabetes may be associated with neurohormonal abnormalities such as elevated cortisol and catecholamines (22). Additional study limitations should be considered.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Analysis of Depressive Symptoms and Glycemic Control in Type 2 Diabetes

et al. 2009

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OBJECTIVETo compare whether depressive symptoms are more strongly related to subsequent or prior glycemic control in type 2 diabetes and to test whether patient characteristics modify these longitudinal associations.RESEARCH DESIGN AND METHODSOn two occasions separated by 6 months, depressive symptoms and glycemic control were assessed in 253 adults with type 2 diabetes. Regression analyses examined depressive symptoms as both a predictor and outcome of glycemic control and tested whether medication regimen (e.g., insulin versus oral drugs) was an effect modifier before and after adjusting for baseline levels of the outcome being predicted.RESULTSDepressive symptom severity predicted poor glycemic control 6 months later (P = 0.018) but not after baseline glycemic control was taken into account (P = 0.361). Although baseline glycemic control did not generally predict depressive symptoms 6 months later (P = 0.558), it significantly interacted with regimen (P = 0.008). Specifically, glycemic control predicted depressive symptoms among patients prescribed insulin (β = 0.31, P = 0.002) but not among those prescribed oral medication alone (β = −0.10, P = 0.210). Classifying depression dichotomously produced similar but weaker findings.CONCLUSIONSDepressive symptoms do not necessarily lead to worsened glycemic control. In contrast, insulin-treated patients in poor glycemic control are at moderate risk for worsening of depressive symptoms. These patients should be carefully monitored to determine whether depression treatment should be initiated or intensified.

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Section: Discussionmentioning

confidence: 99%

Longitudinal Analysis of Depressive Symptoms and Glycemic Control in Type 2 Diabetes

et al. 2009

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“…Because insulin therapy is typically prescribed when glucose cannot be controlled through oral glucose‐lowering agents alone [21], insulin therapy is an obvious marker of more advanced diabetes. Both depression and severe diabetes may be associated with neurohormonal abnormal levels of cortisol and catecholamines [22]. We would further speculate that, as blood glucose becomes more labile, it becomes more strongly related to psychological factors.…”

Section: Discussionmentioning

confidence: 99%

Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen

et al. 2008

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The generally weak association between depression and glycaemic control is concentrated among patients who are prescribed insulin. Similarly, the association between depression and illness quality of life is strongest in patients prescribed insulin. Because this is not attributable to depression-related adherence problems, psychophysiological mechanisms unique to this group ought to be carefully investigated. Clinicians might be especially vigilant for depression in Type 2 DM patients who use insulin and consider its potential impact upon their illness course.

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“…Sachs et al [53]induced emotional arousal in 18 healthy medical students by means of a 45-min interview, which was centered on the most negative event which had occurred 6 months earlier in the subject’s life. The events were reviewed in detail, giving special attention to the interpersonal aspects of the stressful situation.…”

Section: The Psychoendocrine Reaction To Laboratory Stressorsmentioning

confidence: 99%

“…The events were reviewed in detail, giving special attention to the interpersonal aspects of the stressful situation. During the life event interview GH levels increased significantly from baseline, whereas epinephrine, norepinephrine and cortisol levels showed no significant elevations [53]. …”

Section: The Psychoendocrine Reaction To Laboratory Stressorsmentioning

confidence: 99%

Psychological Stress and Neuroendocrine Function in Humans: The Last Two Decades of Research

Biondi

Picardi

1999

Psychother Psychosom

313

175

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This paper reviews experimental contributions published in the last two decades and exploring the effect of emotional stress on neuroendocrine function in healthy humans. Laboratory studies allow standardization of the stressor and better control for known confounding factors. Commonly used stressors are mental arithmetics, speech tasks, the Stroop test, videogame playing, films or videotapes and interviews. Little is known about the generalizability of laboratory results, with some studies suggesting great caution in extrapolating data to real-life stress conditions. Another strategy is studying the psychoendocrine reaction to real-life stressors, such as bereavement or anticipated loss, academic examinations, everyday work and parachute jumping. The effects of different stressors on neuroendocrine axes are reviewed, as well as the influence of gender, age, personality, coping style, social support, biological and nonbiological interventions. The subjective perception of the situation is probably a main determinant of the psychoendocrine response pattern. In fact, marked variability in individual responses to a variety of stressors has frequently been observed. Evidently, the ‘objective’ characteristics of a given event are not the only determinants of reaction to the event itself. According to a constructivistic perspective, every given stressor has a strictly personal and idiosyncratic meaning and loses its ‘objective’ characteristics. Of course, biological factors may also play a part. In any case, it is mandatory to overcome a rigid dichotomy between psychological and biological processes. Dualistic conceptions which imply a determination of the physical by the psychological or vice versa should give place to a systemic conception, which implies mutual, circular interactions.

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Hormonal and blood glucose responsiveness as an indicator of specific emotional arousal in type 1 diabetics

Cited by 14 publications

References 47 publications

Longitudinal Analysis of Depressive Symptoms and Glycemic Control in Type 2 Diabetes

Longitudinal Analysis of Depressive Symptoms and Glycemic Control in Type 2 Diabetes

Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen

Psychological Stress and Neuroendocrine Function in Humans: The Last Two Decades of Research

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