Aggressive diabetes treatment stressful for some

When screening identifies people with type 2 diabetes, they usually experience little anxiety in the first years after the diagnosis. However, early and intensive treatment seems to lead to higher anxiety and less ability to cope, researchers report.

"There is an ongoing debate on screening for type 2 diabetes," Dr. Bart J. Thoolen, of Utrecht University, the Netherlands, and colleagues write in the medical journal Diabetes Care.

"Advocates emphasize the advantages of detecting diabetes in patients at an early stage of the disease," the team explains, as early and intensive treatment may reduce diabetes-related illness and death. Opponents say that is not certain, while the psychological consequences of early detection and treatment are unclear.

To investigate, the researchers studied 196 patients diagnosed with diabetes 3 to 33 months previously who were receiving usual care or intensive treatment.

The majority of patients reported little distress and low levels of perceived seriousness and vulnerability, and felt confident coping with the disease.

However, compared to patients with a more recent diagnosis, those diagnosed between 2 and 3 years previously considered their diabetes more threatening.

Those who received intensive treatment reported more distress and less self-confidence in the first year.

"This study emphasizes the importance of taking variations between patients into account in the development and implementation of (self-care) programs for patients with a recent diagnosis of type 2 diabetes during a screening trial," Thoolen and colleagues conclude.

"It also suggests that clinicians should be more attuned to patients' psychological needs when they first prescribe intensive treatments," they conclude.

SOURCE: Diabetes Care, October 2006.