How type 1 diabetic patients with good or poor glycemic control cope with diabetes-related stress

Objective: To determine the link between glycemic control and the strategie s adopted by patients in coping with diabetes-related stress. Material and methods: In a cross-sectional study of 122 type I diabetic pat ients, glycemic control was evaluated on the basis of the last mean annual HbA(1c) level, and a comparison was made of two groups of patients, i.e., t hose with "good control" (HbA(1c) < 7.5%) and "poor control" (HbA(1c) > 8.5 %). Sociodemographic were collected for all patients by the referring physi cian. The nature of the diabetes-related stress and the coping strategies a dopted by patients were determined by analyzing validated self-assessment q uestionnaires. Results: Comparison showed that there was no significant difference between the two groups in terms of the patients' age, level of education, age at o nset, duration of the diabetes, or the nature of diabetes-related stress fa ctors. In contrast, the difference between the groups was significant in th at patients in the "well controlled" group carried out more home blood gluc ose tests (p < 0.02), had fewer complications (p < 0.003), and made greater use of so-called "task oriented" strategies (p = 0.023), regardless of the existence of any complications. Conclusions: Even though the nature of the diabetes-related stress appears to be the same for the two groups, type I diabetic patients with good glyce mic control manage their condition differently (more frequent home blood gl ucose tests) and use coping strategies that place greater emphasis on probl em solving.