Life events and the control of diabetes mellitus.

The experience of stressful life events was found to be associated with disturbances of diabetic control. Increases in the incidence of glycosuria, changes in prescriptions and frequency of clinic attendance were associated with increases in the reported occurrence of life events. The experience of life events was not reflected in blood glucose measures. Any increases in blood glucose appeared to be registered as glycosuria. Analysis of variance showed that insulin treated groups scored higher on ‘disturbance measures’ than the tablet treated groups. Insulin requiring diabetics were more inclined to have problems with their diabetic management in association with life events than the tablet treated diabetics. GRANT, KYLE, TEICHMAN and MENDLES [I] used a modification of Holmes and Rahe’s Schedule of Recent Events inventory to examine the relationship between the occurrence of life events and the course of illness in a group of diabetic patients. Their findings suggested a relationship between the occurrence of life change and aggravation of the diabetic state although this relationship was not statistically significant. Various of their subgroups of patients (juvenile vs adult onset diabetes; males vs females; insulin requiring vs non-insulin requiring) showed no significant differences in the life events reported, nor in the association between life events and change in physical state. Instead of examining the individual indices of physical state available, Grant and his colleagues used that information to make an overall evaluation of the patients’ condition at each visit. This evaluation was made by a rater who had no contact with the patients. The present study is a development of that of Grant and his colleagues [l]. It examined individual measures of physical state in relation to retrospective measures of life events experienced over a 12 month period. It was hypothesised that the experience of stress in the form of life events would lead to problems in the management of diabetes which would be reflected in poorly controlled blood glucose levels, episodes of glycosuria and changes in treatment requirements.