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Managing Stress Keeps Type II Diabetes in Check

Study shows taking courses can reduce blood sugar levels

FRIDAY, Jan. 4, 2002 (HealthDayNews) -- If you've got Type II diabetes, learning how to relax can lower your blood sugar, new research shows.

A study from Duke University found that patients who took five stress management classes and then incorporated what they learned into their daily lives had, on average, a 0.5 percent drop in their blood sugar levels when compared to diabetics who only took general diabetes education classes.

"This is the first large study to show that a simple, cost-effective treatment can have a meaningful therapeutic effect on the control of blood sugar," says study author Richard Surwit, professor and vice chairman of Duke University Medical Center's department of psychiatry and behavioral sciences. "What we were able to show in this study is that, after a year, there was a significant improvement of the control of glucose in those who had the stress management training. The change is nearly as large as you would expect to see from some diabetes-control drugs."

According to the National Institute of Diabetes and Digestive and Kidney Diseases, there are some 16 million diabetics in the United States, with a total of 798,000 new cases diagnosed each year. Type II, or adult-onset diabetes, is usually diagnosed after the age of 30, and accounts for up to 95 percent of all diabetes cases. Risk factors for Type II diabetes include older age, obesity, family history of diabetes, prior history of diabetes during pregnancy, and physical inactivity.

Blame stress hormones for the spike in blood sugar when you're under pressure. The body reacts to stress by flooding the bloodstream with the same kind of hormones you release when you're in danger -- the "fight or flight" response. The hormones cause the body to release stored sugar into the bloodstream in preparation for the anticipated burst of needed energy.

To see if putting people through stress management classes would lower blood sugar, Surwit and his colleagues randomly assigned 108 patients to either five general diabetes education classes or five classes that combined general diabetes education with stress management instruction.

Those in the stress management classes were taught how to recognize signs of stress. They were then taught to manage that stress -- stopping anxious thoughts, deep breathing and guided imagery, a technique that directs the imagination. In addition, patients were shown how to consecutively tense and relax a prescribed set of muscle groups, starting with the feet and progressing to the head. The result was a deeply relaxed state of mind and body. The patients were told to practice at least twice a day, and to employ the techniques when they felt stressed.

After six months, both groups showed improvement in glucose levels, Surwit says. However, after six months, the general diabetes education group began to show increased glucose levels, while the stress management group continued to improve. By the end of the year, 32 percent of the patients who learned stress management had lowered their glucose levels by 1 percent or more, compared to only 12 percent of the control patients.

"The reason that both groups did well for the first six months is that when you put people into studies, everyone gets better," Surwit explains. "They attend to what they are supposed to be doing; they adhere to their diets, take their medication, and they all get better. But as time goes on, the control group starts to slip back into bad habits, while the stress management group continues to improve."

The findings appear in the January issue of Diabetes Care.

"I'll tell you what I'd advise diabetics to do. Get into a stress management program," Surwit says. "Get a self-help book, attend to what's going on in your lives. People don't need psychotherapy; they don't need a long, drawn-out program. All they need to do is learn some basic stress management skills."

What To Do

For more information on stress and diabetes, see the American Diabetes Association. For more on stress management, visit the International Stress Management Association.

SOURCES: Interview with Richard Surwit, Ph.D., professor and vice chairman, department of psychiatry and behavioral sciences, Duke University Medical Center, Durham, N.C.; January 2002 Diabetes Care
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