Impact of Psychological Stress caused by the Great East Japan Earthquake on Glycemic Control in Patients with Diabetes

Department of Endocrinology and Metabolism, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.
Experimental and Clinical Endocrinology & Diabetes (Impact Factor: 1.76). 07/2012; 120(9):560-3. DOI: 10.1055/s-0032-1314873
Source: PubMed

ABSTRACT We examined the relationship between psychological stress and the worsening of glycemic control in diabetic patients at the time of the Great East Japan Earthquake. HbA1c levels in diabetic patients before and after the disaster were evaluated with the General Health Questionnaire (GHQ) and other questions including those on changes in diet, exercise, psychological stress and drug intake in 320 consecutive diabetic patients who had been followed in a diabetes clinic. Logistic regression analysis revealed that the total GHQ scores (odds ratio [OR] 1.03 [95% confidence interval 1.01-1.06]; p<0.01) and interruption of drug intake (OR 4.48 [1.57-12.7]; p=0.01) were independently associated with worsening of glycemic control defined as an increase in the HbA1c level equal to or greater than 0.5%. Among the scores on the GHQ, those for somatic symptoms (OR 1.18 [1.01-1.38]; p=0.03) and sleep disturbances or anxiety (OR 1.26 [1.08-1.46]; p<0.01) were independently associated with glycemic control. These results suggest that psychological stress during a disaster has independent effects on worsening of glycemic control.

  • [Show abstract] [Hide abstract]
    ABSTRACT: To examine the association between glycosylated hemoglobin (HbA1c) and four subscales of work-related psychosocial stress at study baseline and over time. We used survey data from a major HMO located in the Southeastern part of the US on health and healthy behaviors linked with patients' clinical, pharmacy and laboratory records for the period between 2005 and 2009. Study participants (n=537) consisted of working adults aged 25-59 years, diagnosed with diabetes mellitus (DM) but without advanced micro or macrovascular complications at the time of the survey. We estimated the baseline (2005) association between HbA1c and work-related psychosocial stress and their interactions using linear regression analysis. Using individual growth model approach, we estimated the association between HbA1c over time and work-related psychosocial stress. Each of the models controlled for socio-demographic variables, diet and physical activity factor, laboratory factor, physical examinations variables and medication use in a hierarchical fashion. After adjusting for all study covariates, we did not find a significant association between work-related psychosocial stress and glycemic control either at baseline or over time. Among fairly healthy middle aged working adults with DM, work-related psychosocial stress was not directly associated with glycemic control. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.
    03/2015; 9(2). DOI:10.1016/j.dsx.2015.02.003
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Current guidelines for the treatment of type 2 diabetes focus on pharmacological treatment of glucose and cardio-vascular risk factors. The aim of this prospective randomized controlled intervention study was to examine the effects of a psychosocial intervention on clinical endpoints and risk factors in patients with type 2 diabetes and early diabetic kidney disease.110 patients were randomized to receive an 8-week mindfulness-based stress reduction (MBSR) training (n=53) compared to standard care (n=57). The study was carried out open-labelled and randomization was performed computer-generated in a 1:1 ratio. Primary outcome of the study was the change in urinary albumin excretion (albumin-creatinine-ratio, ACR); secondary outcomes were metabolic parameters, intima media thickness (IMT), psychosocial parameters and cardiovascular events.89 patients (42 in control group and 47 in intervention group) were analysed after 3 years of follow-up. After 1 year, the intervention group showed a reduction of ACR from 44 [16/80] to 39 [20/71] mg/g, while controls increased from 47 [16/120] to 59 [19/128] mg/g (p=0.05). Parallel to the reduction of stress levels after 1 year, the intervention-group additionally showed reduced catecholamine levels (p<0.05), improved 24 h-mean arterial (p<0.05) and maximum systolic blood pressure (p<0.01), as well as a reduction in IMT (p<0.01). However, these effects were lost after 2 and 3 years of follow-up.This is the first study to show that a psychosocial intervention improves cardiovascular risk factors in high risk type 2 diabetes patients. Trial-Registration: NCT00263419 Trial registration: NCT00263419.
    Experimental and Clinical Endocrinology & Diabetes 05/2014; 122(6). DOI:10.1055/s-0034-1372583 · 1.76 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Older adults are one of most vulnerable populations at the onset of disasters. Those survived could suffer from life- and environmental changes originated in the disaster. As disuse syndrome or solitary death are often referred as disaster-related morbidity and mortality among older survivors, their physical activity patterns should be given a greater attention. Objective: The study aims to describe physical activity patterns of older people affected by a major natural disaster, and explore contexts of such PA patterns in terms of socio-ecological factors. Method: A mixed approach was taken to obtain a holistic view of the situation. IPAQ-SF and pedometers were used for measuring PA of older adults ≧65 (n=80) living either in temporal housing or their own dwelling located in two cities in Japan. One-on-one interviews were conducted to 1 male and 30 female subjects from the same group. Results: IPAQ scores showed internal correlations among PA intensities: between total PA and moderate-intensity PA (Pearson correlation .54, p=.000) and also between total PA and walking time (.87, p=.000). Mean daily steps suggested a low PA profile of the female group (μ3825.05, SD±2563.05) and positively correlated with non-migration (μdifference 2128.04, p=.029). As for the total PA, temporary housing dwellers reported significantly greater PA than those who live in their own house (p=.036). The difference in moderate PA was also significant between two groups, with greater PA among temporary housing residents (p=.002). Interviews explained some context of the observed PA pattern difference. Conclusions: Total and moderate PA were mediated by forced relocation. PA programs in temporal housing implemented regularly may have contributed to see greater PA level among the migration group. But lack of amenities in the neighbourhood limited their daily walking. This study result merits replication with a larger sample and also an assessment of physical environment of the area.
    12/2013, Degree: Master of Science by advanced study in Nutrition, Physical Activity and Public Health, Supervisor: Mark Davis