FACTORS RELATED TO STRESS IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

Stress was assessed using State-Trait Anxiety Inventory scores in 40 n on-insulin-dependent diabetes mellitus (NIDDM) patients, and the resul ts were compared with those for 40 sex- and age-matched healthy contro ls. Fludiazepam was administered to the patients for 12 weeks and stre ss was reassessed. The Manifest Anxiety Scale score correlated with Tr ait (r = 0.548, P < 0.0001) and State (r = 0.474, P = 0.0001) scores, validating the latter as measurements of stress. Both Trait (43.4 vs 3 5.8, P < 0.001) and State (41.6 vs 33.8, P < 0.001) scores were signif icantly higher in NIDDM patients than in healthy controls. Administrat ion of an anxiolytic, fludiazepam (0.25 mg, three times daily, orally) for 12 weeks lowered Trait score (43.5 to 36.9, P < 0.0001), State sc ore (41.6 to 35.8, P < 0.0002), glycosylated haemoglobin (8.4 to 7.3%, P < 0.0001), systolic blood pressure (151.2 to 143.4 mmHg, P < 0.0017 ) and diastolic blood pressure (84.2 to 77.7 mmHg, P < 0.0018). Multip le regression analysis revealed that the significant explanatory varia bles for the change in State score during anxiolytic administration we re the changes in total cholesterol, high-density lipoprotein choleste rol, triglycerides, apolipoprotein B:A1 and glycosylated haemoglobin ( R(2) = 0.3224, P < 0.0022). The results indicate that stress is detect ed at a higher frequency in patients with NIDDM than in healthy contro ls, and that blood glucose and lipid metabolic factors are significant explanatory variables for this stress. This stress is correlated with glucose metabolism and blood pressure and, moreover, these factors co uld all be proved concomitantly by the administration of an anxiolytic .