Relationship between duration of type 2 diabetes mellitus and stress levels based on age, gender, anthropometry and vital signs
Keywords:Type 2 diabetes mellitus, Perceived stress, Gender, Anthropometry, Vital signs
Background: The incidence of diabetes mellitus is increasing at a rapid rate and by 2030 the case load would be doubled. Stress and various other factors such as physical and psychological factors play a significant role in the worsening of hyperglycemia in patients with type 2 diabetes mellitus. Aim and objective was to study the relationship between duration of type 2 diabetes mellitus and stress levels based on age, gender, anthropometry and vital signs.
Methods: After obtaining approval from the institute ethics committee for human studies, the present study was conducted in the Department of Physiology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu on 50 type 2 diabetes mellitus patients (25 males, 25 females). After obtaining informed, written consent the following parameters such as duration of diabetes mellitus (Months), anthropometric parameters such as Body Mass Index (BMI), Waist Hip Ratio (WHR), Perceived Stress Scale (PSS) Scores, Vital signs viz. Pulse Rate (PR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Respiratory Rate (RR) were recorded in all the study participants. Data for all the parameters was collected as per the study protocol and computerized in Microsoft excel database. All statistical analyses were done at 5% level of significance and P<0.05 was considered as statistically significant.
Results: Average age of male and female volunteers was 52.16 ± 12.20 years and 55.68 ± 9.68 years respectively. Statistical analysis using independent Student’s 't’ test, showed that there was no significant gender difference on the above mentioned parameters. Pearson’s correlation showed a statistically significant association between duration of diabetes mellitus and BMI (P<0.01). Correlation between duration of diabetes mellitus and PSS scores was also statistically significant (P=0.02).
Conclusions: Results of the present study indicate that stress and increase in BMI are important independent risk factors for the worsening of hyperglycemia. When there is presence of other co morbid conditions the risk may be increased or it may affect the management or prognosis.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53.
WHO. Diabetes Fact sheet N°312, October 2013. Available at: http://www.who.int/mediacentre/factsheets/fs312/en/. Accessed January 2015.
Dan L. Longo, Antony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo. Diabetes mellitus. In: Dan L. Longo, Antony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo, eds. Harrison’s Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill Professional; 2012: 2968-3002.
Dinesh Thangavel, Vijaiananth Pitchaipillai. Association of duration of illness and compliance with stress levels in type 2 diabetes mellitus patients - a pilot study. Natl J Physiol Pharmacol. 2014;4(3):249-51.
Kumar Vinay, Fausto Nelson, Abbas Abul K, Cotran Ramzi S, Robbins Stanley L. Stress. In: Kumar Vinay, Fausto Nelson, Abbas Abul K, Cotran Ramzi S, Robbins Stanley L, eds. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia: Saunders. 2005: 1194-1195.
Leon KA, Hyre AD, Ompad D, DeSalvo KB, Muntner P. Perceived stress among a workforce 6 months following hurricane Katrina. Soc Psychiatry Psychiatr Epidemiol. 2007;42(12):1005-11.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983:24(4):385-96.
Cathy Lloyd, Julie Smith, Katie Weinger. Stress and diabetes: a review of the links. Diabetes Spectr. 2005;18(2):121-7.
Shlomo Melmed, Kenneth S. Polonsky, P. Reed Larsen, Henry M. Kronenberg. Stress and diabetes. In: Shlomo Melmed, Kenneth S. Polonsky, P. Reed Larsen, Henry M. Kronenberg, eds. Williams’s Textbook of Endocrinology. 12th ed. Philadelphia: Elsevier/Saunders; 2011: 1371-1435.
Ganong WF. Cardiovascular regulatory mechanisms. In: Ganong WF, eds. Review of Medical Physiology. 22nd ed. San Francisco: McGraw Hill; 2005: 597-602.
Viner R, McGrath M, Trudinger P. Family stress and metabolic control in diabetes. Arch Dis Child. 1996;74:418-21.
Bays HE, Chapman RH, Grandy S. The relationship of body mass index to diabetes mellitus, hypertension and dyslipidaemia: comparison of data from two national surveys. Int J Clin Pract. 2007;61(5):737-47.
Abdullah A, Peeters A, de Courten M, Stoelwinder J. The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies. Diabetes Res Clin Pract. 2010;89(3):309-19.
Huang ES, Brown SE, Ewigman BG, Foley EC, Meltzer DO. Patient perceptions of quality of life with diabetes-related complications and treatments. Diabetes Care. 2007;30(10):2478-83.
Jerath R, Edry JW, Branes VA, Jerath V. Physiology of long pranayama breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Med Hypotheses. 2006;67:56-71.
Dinesh T, Venkatesan R, Venkidusamy S. Effect of 12 weeks of pranayama training on basal physiological parameters in young, healthy volunteers. Panacea J Med Sci. 2014;4(1):28-30.