How teens face stress may affect diabetes control

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The approach teenage diabetics take to coping with problems may help determine how well they manage their disease, according to a new study.

Researchers found that among 103 teens with type 1 diabetes, those with more positive, practical responses to life’s difficulties showed better blood sugar control than those who had more negative attitudes.

In general, teens who said that when faced with a problem, they resolve to do something about it—what researchers call “active coping”—had better long-term control over their blood sugar levels.

On the other hand, those who said they dealt with stress by getting angry or by giving up showed poorer blood sugar control, according to findings published in the journal Diabetes Care.

The results suggest that counseling focused on teens’ “coping styles” should be integrated into routine diabetes care, according to lead study author Marit Graue, of Haukeland University Hospital in Bergen, Norway.

Unlike the much more common type 2 diabetes, which usually arises in middle age or later, type 1 diabetes is an autoimmune disease that typically begins in childhood. It leaves people with the disorder dependent on daily insulin injections—or in some cases, an implanted insulin pump—for the rest of their lives.

Avoiding patterns of extreme highs and lows in blood sugar is key to staving off the long-term complications of diabetes, which include heart disease, kidney failure, vision loss and nerve damage in the limbs.

It’s possible, Graue told Reuters Health, that kids who favor active coping are more likely to watch their diets, closely follow their prescribed insulin regimens or take other actions that lead to better blood sugar control.

For the study, Graue’s team surveyed 103 13- to 18-year-olds on how they typically coped with problems, and then looked at the relationship between different coping styles and the results of the teens’ HbA1c tests, which reflect average blood sugar levels in recent months.

While active coping was associated with better HbA1c values, getting angry or feeling helpless in the face of problems were both linked to poorer blood sugar control.

It’s not clear that these attitudes were the reasons for the teens’ better or worse blood sugar levels, Graue noted. For example, having a tough time managing blood sugar highs and lows could make kids more negative, the researcher explained.

However, Graue pointed out, there is research indicating that when people with diabetes are taught coping skills, it improves their blood sugar control and quality of life.

SOURCE: Diabetes Care, June 2004.

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