The Relationship of Stress and Coping to Regimen Adherence and Glycemic Control of Diabetes

The purpose of this study was to assess relationships among stress, coping, regimen adherence, and glycemic control in adults with insulin-dependent diabetes mellitus (IDDM). A total of 39 subjects completed measures of perceived stress, the occurrences of stress in everyday living (daily hassles), coping in relationship to a diabetes-specific stressful event, and coping in relationship to a daily hassle. In addition, subjects self-monitored their insulin injections, glucose testing, and food intake for 1 week and provided a blood sample for measurement of glycemic control. Results indicated that higher levels of perceived stress (but not daily hassles) were associated with poorer glycemic control. More avoidant coping was also related to poorer control. Neither the stress nor the coping measures were consistently associated with adherence. Finally, increased coping failed to moderate the influence of stress on metabolic control. Taken together, these results provide support for a direct relationship between stress and diabetes control, but they do not support the hypothesis that the interaction of stress and coping affects adherence and glycemic control in IDDM.