[Association between psychological stress and metabolic control in patients with type 1 diabetes mellitus].

BACKGROUND An association between psychological stress and metabolic control can occur in patients with diabetes. AIM To determine the longitudinal association between different psychological stress domains (emotional burden, physician-related distress, regimen-related distress, diabetes-related interpersonal distress) and metabolic control of adolescents with Type 1 diabetes. MATERIAL AND METHODS An intentional sample of 20 Type 1 diabetic adolescents aged 15 ± 4 years was followed-up for one year. Three HbA1c determinations were performed and a stress self-report was obtained with the Polonsky' Diabetes Distress Scale. RESULTS Several analyses were conducted using growth curve modeling. The first model included the HbA1c measures, the time term (coded as 0, 1, 2) and several covariates (age, years living with type 1 diabetes mellitus, sex, and physical activity). An overall negative linear trend was found for HbA1c. Subsequent models added the stress domains finding that high levels of emotional burden and regimen related-distress were associated with higher HbA1c levels across all exams. A marginal association was found between diabetes-related interpersonal distress and HbA1c. CONCLUSIONS Stress levels in type 1 diabetic adolescents deserve attention. Different psychological stress factors predicting metabolic control trajectories in type 1 diabetic adolescents were found.