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The Psychology of Sickness

Researchers find physical-emotional link in diabetics' well-being

SUNDAY, Aug. 26, 2001 (HealthDayNews) -- Call it a classic case of the mind-body connection. A new study of Type I diabetics says a person's emotional and physical well-being are strongly interrelated.

In investigating the physical-mental relationship in diabetics, researchers at the University of South Carolina surveyed 49 adults on a variety of topics. The topics included the impact the illness has on their life, the degree of stress or negative emotions they experience, how they cope with the disease, and whether anticipation of future complications affects them.

The researchers also evaluated the patients' physical health, including the severity of their diabetes and blood sugar levels.

As expected, the results showed that those who felt better physically also felt better mentally.

"The data showed that the more positive the attitude toward the illness, the better the patients' mental and physical health," says study author Dr. Kay McFarland, an endocrinologist at the University of South Carolina School of Medicine.

"And it goes both ways -- the people who reported being more negatively impacted by the illness mentally had higher blood sugar," McFarland says.

The results appear in the current issue of the journal Endocrine Practice.

People with Type I diabetes don't produce any insulin, and must take daily insulin injections to stay alive. The condition most often occurs in children and young adults and accounts for 5 to 10 percent of diabetes cases.

Those in the survey who had higher blood sugar -- hence less-controlled diabetes -- reported experiencing more stress and more trouble coping with the illness. They also anticipated more complications in the future.

Whether the high blood sugar caused the less-upbeat attitude, or vice-versa, is up for speculation, says McFarland.

"You can say it goes both ways: that health affects the way you feel about your illness, and the way you feel about your illness affects your health. There's not necessarily a particular cause-and-effect that was established, but they're interrelated," McFarland says.

Dr. Zachary Bloomgarden, an associate clinical professor at Mount Sinai School of Medicine in New York City, says it's not hard to understand either the physical or emotional toll a disease like Type I diabetes can take.

"People with diabetes are ill, and people who are ill are often depressed -- and maybe people with diabetes are even more depressed," he says. "The fact is, if you have diabetes, you have [a high risk of] heart disease, high cholesterol, high blood pressure; you're on six or eight different pills, and it really becomes almost a way of life to have the illness."

"So I can easily see how this can go in both directions -- the [physical and emotional factors] are tremendously interrelated," he adds.

McFarland says as long as there's evidence that a person's attitude can directly affect the physical aspects of his illness, it's up to doctors to help him keep a positive attitude.

"The conclusion from this is that many of us in medicine tell everyone that high blood sugar is going to cause problems, such as eye and kidney problems," McFarland says. "My feeling is to downplay that and try saying, 'Hey, let's find ways to get your blood sugar down and instead of concentrating on the bad outcome, let's concentrate on what we can do to make a difference.' "

"I'm a believer in individual power and the ability to determine our own outcomes, and it's my job to help other people believe that, too," McFarland adds.

What To Do: Visit the American Diabetes Association to learn more about Type I diabetes. And here's some helpful information on stress and diabetes.

SOURCES: Interviews with Kay McFarland, M.D., professor of medicine, endocrinologist, University of South Carolina School of Medicine, Columbia; Zachary Bloomgarden, M.D., associate clinical professor, department of medicine, Mount Sinai School of Medicine, New York City; July/August 2001 issue of Endocrine Practice
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