Psychological coping may help boost glycaemic control in type 2 diabetes

An adaptive emotion-focused coping mechanism for stress appears to improve glycaemic control in type 2 diabetes mellitus (T2DM) patients who do not use insulin, a new study suggests.

Researchers enrolled 503 T2DM patients (mean age, 63.9±12.6 years; 60 percent male) whose coping profiles were evaluated using the Brief Scale for Coping Profile (BSCP) tool. Glycaemic control was determined through glycated haemoglobin (HbA1c) measurements, taken four times per year. Moderate-to-severe dementia, blindness and severe mental illnesses were criteria for exclusion.

Univariate analysis found that none of the coping dimensions and profiles were significantly predictive of glycaemic control in T2DM patients. The significant indicators that emerged were age, body mass index, alcohol use and insulin use. Participants were then stratified according to insulin use.

Insulin subgroups were mostly comparable in terms of demographic factors, exercise frequency, depression, and coping dimensions and profiles. The only exception was HbA1c, which was significantly elevated in users (p=0.000).

Repeating the univariate linear regression analysis for predictors of glycaemic control, the researchers found a significant modifying effect of insulin use. For instance, an adaptive emotion-focused coping dimension was significantly correlated with glycaemic control in patients who were not on insulin (r, –0.216; p=0.000). Among insulin users, none of the coping dimensions yielded significant effects on glycaemic control.

The present findings suggest that “psychological therapy focusing on stress management using adaptive emotion-focused coping, such as cognitive-behavioural therapy, may improve glycaemic control,” researchers said.