Study shows life experience critical for managing Type 2 diabetes

Age plays a critical role in the wellbeing of people newly diagnosed with Type 2 diabetes, with younger patients more susceptible to psychological distress resulting in worse health outcomes, according to a new study by researchers at Carnegie Mellon University and published the Journal of Behavioral Medicine.

Currently about 27 million people in the United States live with Type 2 diabetes. Past research has shown that stress associated with diabetes management leads to poor blood sugar control.

In the study, the team evaluated 207 patients who were diagnosed with Type 2 diabetes within the past two years. They used several surveys to evaluate health, psychological distress, and healthcare, as well as studied the participants' daily dairies to identify stressors. The researchers assessed patients at the start of the study to establish a baseline and then six months later. They examined the results regarding gender, race, ethnicity, age, education, employment, income, relationship status, and use of medication.

They found younger patients, 42 years old and younger, experienced higher diabetes-related and psychological distress. In addition, patients with higher education and income expressed more stress. Conversely, older patients, older than 64 years old, had less psychological stress and greater consistency in self-care, blood sugar control, and medication adherence. Patients in long-term relationships also reported less diabetes stress.

Patients identified diet as the greatest stressor (38 percent). Other significant stressors include checking blood sugar (8 percent) and experiencing high or low blood sugar events (7 percent). Patients who self-reported greater stress also reported greater depressed mood, less adherence to medication, and higher anxiety.

While the study was not designed to explore why patients handle stressors differently, researchers believe older adults may live in the present compared to younger adults, whose focus on the future may magnify their stressors. Diabetes is also more common as people age, and older patients may find more support from their peer group. The researchers also suggest older adults may leverage past experiences to employ emotion regulation strategies to mitigate the stress associated with managing the disease.

After a diagnosis, many patients experience stress as they modify their lifestyle to accommodate diet, weight control, medication, and exercise routines, which can be time-consuming, complicated, and costly. Complications from diabetes include heart disease, stroke, kidney disease, and lower limb amputations.

The study was not designed to interpret the cause of underlying stressors or identify emotion regulation strategies, according to Vicki Helgeson, PhD, senior author of the study and professor of psychology. In addition, the daily stress measure was not developed to expand on the nature of the stressor. Future studies could evaluate how patients react to stressors to develop effective intervention and regulation strategies for different age, gender, and cultural groups.

"Diabetes care is difficult, because it requires a lifestyle change that you have to do forever," Helgeson said. "Life gets in the way of sticking to a diabetes regimen."