War-induced prolonged stress and metabolic control in Type 2 diabetic patients

Abstract

Synopsis: Sound evidence that psychological stress may significantly worsen metabolic control in diabetic patients is lacking. The stressful effects of war on glycaemia control have not been assessed as yet. A randomly selected sample of displaced Type 2 diabetic persons (N= 44) was compared to a matched group of diabetic persons who had not been forced to leave their homes. The self-reported stress, depression level, fasting and post-prandial blood glucose, glycosylated haemoglobin and serum lipids were compared. The two groups were found to be significantly different in scores for self-reported stress and depression levels (P< 0·001). The proportion of subjects belonging to the category of clinically significant depression was larger in the group of displaced persons (P< 0·001), as well as the proportion of extreme scores for self-reported stress (P< 0·001). No significant differences between the groups were found for variables measuring metabolic control (P> 0·05), except for the serum triglycerides which were found to be significantly higher in the group of displaced persons (P< 0·01). This is assumed to be the result of differences in nutrition. The results do not demonstrate an association between prolonged stress and glycaemic control in Type 2 diabetic patients. The variability of data measuring stress and depression level in two extreme groups with respect to HbA_1cvalues suggests that individual factors which determine the response to stressors need to be explored.