J. Metsch et al., ON THE RELATION AMONG PSYCHOLOGICAL DISTRESS, DIABETES-RELATED HEALTHBEHAVIOR, AND LEVEL OF GLYCOSYLATED HEMOGLOBIN IN TYPE-I DIABETES, International journal of behavioral medicine, 2(2), 1995, pp. 104-117
This study aimed at investigating the relation between psychological d
istress, diabetes-related health behavior, and metabolic aspects of di
abetes. Fifty-one adult patients with type I diabetes mellitus took pa
rt in the study. Psychological status, health, and self-care behavior
were assessed by means of questionnaires. Level of glycosylated hemogl
obin (HbA(lc)) served as the index of metabolic control. Depression wa
s slightly elevated among women as was trait anxiety and blood-injury
phobia or fear of medical interventions in all patients. Depression an
d anxiety were not related to duration of diabetes or presence of diab
etes complications. As could be expected, patients who frequently chec
ked their blood glucose level had a significantly lower level of HbA(l
c) than those with infrequent checks. Patients with a marked blood-inj
ury phobia carried out fewer daily checks of blood glucose level than
those without, but blood-injury phobia was not directly related to HbA
(lc) level. A higher level of HbA(lc) was, however, associated with mo
od deterioration. As depression was not related to health behavior, it
s effect on metabolic control is likely to be mediated via endocrine r
ather than behavioral variables.