Psychologic stress and glycemic control: a comparison of patients with and without proliferative diabetic retinopathy.

Abstract

Using a case/control design, patients with (cases) and without (controls) proliferative diabetic retinopathy were compared using three psychosocial measures: life events, psychiatric symptomatology, and ego development. Cases reported significantly more symptoms. They also demonstrated a modest and significant correlation of negative life events with HgbA1c that was not shown in the controls. When the relationship of life events with glycemic control was explored in cases of varying durations of proliferative retinopathy, we found that the association between negative life events and HgbA1c was accounted for by the cases with a recent onset of retinopathy. Patients in this recent group showed a trend towards more negative life events that decreased with longer duration of proliferative retinopathy. This study suggests that the onset of proliferative retinopathy portends a life crisis during which metabolic control is sensitive to additional life stress and that this association is not found among patients whose illness is more stable.

The role of socioeconomic status, depression, quality of life, and glycemic control in type 1 diabetes mellitus

“…Despite receiving oral medication and psychotherapy for depression, these subjects indicated that their depressive symptoms were exacerbated after the onset of T1DM. [34][35][36][37][38] We thank Dr. E. O'Brian Smith for his help with the statistical analysis of the data. We also thank the faculty, Nurse Practitioners, Certified Diabetes Educators, Registered Nurses, and auxiliary staff of the Diabetes Clinic for help in recruiting subjects.…”

Is depression associated with microvascular disease in patients with type 2 diabetes?

“…However, other studies provide additional supporting evidence. Jacobson et al [1985] found that proliferative diabetic retinopathy heralded the onset of depression in patients with type 1 diabetes. Miyaoka et al [1997] also reported an association between retinopathy and mood symptoms in patients with type 2 diabetes.…”

Gendered Trajectories of Work Control and Health Outcomes in the Middle Years

“…First, poor mental health attributed to lack of work control can also contribute to the development and/or progression of a wide range of common medical conditions such as joint pains, pruritus, psorasis, and urticaria (Carney & Freedland, 2000). In particular, depression has been associated with diabetes and poorer metabolic control (Garvard, Lustman, & Clouse, 1993;Jaconson, Rand, & Hauser, 1985). Second, lack of control at work imposes structural constraints on choices regarding healthrelated behaviors and may result in an unhealthy lifestyle (Wickrama et al, 1995).…”