Aberrant parasympathetic and hemodynamic function distinguishes a subgroupof psychologically distressed individuals with asymptomatic type-I diabetes mellitus

In a previous study, a subgroup of asymptomatic insulin-dependent diabetic individuals (termed IDDM-2) were identified on the basis of diminished para sympathetic cardiac input and elevated heart rate at rest. When compared to another group of asymptomatic IDDM participants (termed IDDM-1), and a non diabetic healthy control group, the IDDM-2 group displayed elevated blood p ressure, supported by elevated total peripheral resistance. Measures of psy chological regulation were also taken in this study, and form the basis of this article, which examined whether these IDDM-2 patients differed from th e other two groups on these measures. The possible role of glycemic control , IDDM duration, and number of somatic complaints among group differences i n psychological regulation was also examined. The IDDM-2 group reported inc reased psychological distress, as reflected by increased dysphoric or depre ssive symptoms, trait anxiety, perceived stress, and cynical hostility, as well as decreased optimism and interpersonal, but not family, social suppor t. Glycemic control did not account for any of the group differences in psy chological regulation. However, group differences in dysphoria and anxiety were accounted for by differences in somatic complaints, whereas difference s in interpersonal social support were accounted for by IDDM duration. More over, none of the variables investigated accounted for the diminished optim ism of the IDDM-2 group. Therefore, in individuals with IDDM, who would oth erwise be considered, after medical examination, as no different from other asymptomatic IDDM individuals, the combination of diminished parasympathet ic cardiac input and elevated heart rate was associated with aberrant alter ations of both hemodynamic and psychological functioning; the increased psy chological distress in these individuals may be influenced, in part, by inc reased diabetes duration and number of somatic symptoms.