Psychosocial stress and use of psychosocial support in patients with diabetes mellitus

Background: In a multicenter study the association of psychosocial stress a nd the use of psychosocial support in patients with diabetes mellitus were evaluated. Patients and Method: In a sample of 410 patients with diabetes mellitus (Ty pe I:n 157, Type II:n = 253) stress in different facets of daily life was a ssessed using the revised Questionnaire on Stress in Patients with Diabetes (QSD-R). Self-constructed items were used to assess the use of psychosocia l support during the course of the illness. Diabetes with a mean global str ess score above standard deviation were defined as extremely handicapped an d compared to the less handicapped sample. Results: Extreme psychosocial stress could be found in 68 diabetics (16.6%) . Not the type of diabetes but the use of insulin within the Type-II diabet ic sample revealed an impact on psychosocial stress. Diabetics with extreme psychosocial stress showed worse diabetic control compared to less stresse d diabetics. Profiles of psychosocial stress showed maximal stress with reg ard to depression in both types of diabetes; this was followed by fear of h ypoglycemia in the sub-sample of Type I and physical complaints in the sub- sample of Type-II diabetics. Family members, primary care physicians and di abetologists were the main sources of psychosocial support. Conclusions: A considerable number of diabetic patients suffers from extrem e psychosocial stress often associated with poor diabetic control. These pa tients need psychosocial care which should primarily be offered in diabetol ogic centers incorporating both the patients' family and family background.