Psychological factors can have a profound effect on the ability of people with diabetes to control their blood sugar, according to scientists at the Medical College of Ohio. Among diabetic patients who learned relaxation techniques with biofeedback, those with the highest levels of depression, anxiety, and daily stress were least successful in reducing their blood sugar.
"Patients with symptoms of depression and frequent daily hassles may have found the demands of the treatment plan too hard and may have not adhered to recommendations for home practice of relaxation," said Angele McGrady, PhD, co-author of the study.
McGrady, along with James Horner, MD, studied 18 adults with insulin dependent diabetes. Half of the participants in the study received medical care and kept logs of their daily blood sugar readings. The other half also learned biofeedback-aided relaxation techniques in 12 sessions, each lasting 45 minutes, and were encouraged to practice them twice a day at home. The scientists report their findings in the current issue of Applied Psychophysiology & Biofeedback.
Four weeks after the treatment ended, the researchers were surprised to find no significant difference in blood sugar levels between those who received biofeedback and relaxation therapy and those who did not. However, when they looked closer, they found evidence that relaxation training did benefit some patients--those not suffering from depression and anxiety.
Among 12 patients who were not depressed, those who practiced relaxation techniques lowered their blood sugar levels about 9 percent, with no change in those who did not. Similarly, among nine patients who were not anxious, those who practiced relaxation techniques reduced their blood sugar levels by about 12 percent, with no change in those who did not.
"Subjects characterized by relatively high depression and anxiety scores took longer to complete the treatment protocol, which may be reflective of poorer adherence," said McGrady. "These participants did not derive benefit from a treatment where no specific psychotherapy or pharmacological therapy for the emotional symptoms was provided."
Other researchers have found that treatment with cognitive behavioral therapy (CBT) or serotonin reuptake inhibitor antidepressants can improve mood and blood sugar control in diabetics with depression. The scientists plan to study the benefits of adding CBT or anti-depressants to biofeedback and relaxation therapy in diabetes treatment.
The research was supported by a grant from the Office of Alternative Medicine, National Institutes of Health.
Applied Psychophysiology & Biofeedback is an international peer-reviewed journal published by Kluwer Academic/Plenum Publishers in association with the Association for Applied Psychophysiology and Biofeedback. For further information about the journal, contact Frank Andrasik, PhD, at (850) 474-2292.
Posted by the Center for the Advancement of Health < http://www.cfah.org >. For information about the Center, call Petrina Chong, < pchong@cfah.org > (202) 387-2829.
Journal
Applied Psychophysiology and Biofeedback