Stress management improves long-term glycemic control in type 2 diabetes
Stress management improves long-term glycemic control in type 2 diabetes
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DOI：
10.2337/diacare.25.1.30
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发表时间：
2002-01-01
期刊：
影响因子：
16.2
通讯作者：
Lane, JD
中科院分区：
文献类型：
--
作者：
Surwit, RS;van Tilburg, MAL;Lane, JD
目的：关于压力管理训练在糖尿病治疗中的效用，有相互矛盾的证据。少数显示压力管理有治疗效果的研究使用了时间密集的个体治疗。不幸的是，广泛使用这种干预措施是不现实的。本研究的目的是确定一个具有成本效益的、基于群体的压力管理训练计划是否可以改善2型糖尿病患者的糖代谢，并确定一个特定的患者亚群是否更有可能获得积极的结果。研究设计和方法：2型糖尿病患者被随机分为五组，分别接受有或没有压力管理培训的糖尿病教育项目。参与者（n = 108）随访1年，在此期间，定期进行HbA（1c）测试和评估感知压力、焦虑和心理健康的问卷调查，以评估治疗效果。结果：压力管理培训与HbA（1c）的小幅（0.5%）但显著降低相关。对治疗方案的依从性随着时间的推移而下降，但与在诊所因其他原因接受压力管理的患者相似。特质焦虑（衡量焦虑倾向的稳定个体差异）并不能预测对治疗的反应，这表明高度焦虑的患者并没有从训练中获得更多的益处。结论：目前的研究结果表明，在“现实世界”环境中，一个具有成本效益的群体压力管理项目可以为非2型糖尿病患者带来显著的临床益处。
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 from 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 = 108) were followed for I 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 but type 2 diabetes.