You hear people talk about life being stressful, or that we live in stressful times. But this way of thinking portrays stress as something that comes to us from an external source – something we get bombarded with.
The fact is, life is demanding and times are difficult (as they always have been), and stress is our reaction to demands and difficulties. Stress happens on the inside. And that’s good news, really, because while we can’t always control the demands and difficulties of life, we do have the ability to control stress. And – more good news – a new study shows that controlling stress may significantly improve the health concerns of type 2 diabetics.
Instruction for less stress
When insulin fails to deliver sugar from the blood to the cells, the resulting buildup of glucose in the blood creates the condition known as type 2 diabetes. The American Diabetes Association suggests three ways to lower elevated blood glucose levels: meal planning, exercise, and weight loss. Searching for another way to help in this effort, researchers at the Duke University Medical Center recently set out to determine if stress management might improve glucose metabolism in subjects with type 2 diabetes.
The Duke team created a stress management program with three primary elements: behavioral skill instruction to help subjects identify major stress sources and how to cope with them; education on the ways that stress can affect health; and demonstrations of a physical technique called progressive muscle relaxation.
The Duke team examined a group of 72 subjects with type 2 diabetes. All of the subjects participated in a five-session education program about diabetes. A little over half of the subjects received the additional group-based stress management program, which also ran five sessions. After the sessions, all of the subjects were followed for one year, participating in occasional questionnaires to assess anxiety, psychological health and perceived stress. Also during this follow-up year, all of the subjects’ hemoglobin A1C (HbA1c) levels were measured at regular intervals. HbA1c is the marker that is measured to assess type 2 diabetes.
At the end of the year, 32 percent of the stress management group recorded HbA1c levels that were lower by one percent or more. In the group that received only diabetes education, 12 percent showed a similar drop in HbA1c. Although these small changes appear to be unimpressive, the researchers noted that even a half percent reduction in HbA1c levels have been shown to produce a significant decrease in diabetic complications. The report concluded that group stress management would be a valuable addition to any program of therapy in addressing type 2 diabetes.
Helping the heart
Last winter I sent you an e-Alert (“Research Reveals the Most Effective Action you can take to Prevent a Heart Attack” 2/14/02) about another stress study from the Duke University Medical Center in which they tested a group of men with coronary artery disease, using a research design similar to the one used in the type 2 diabetes study. In the cardiac trial, the results were much the same: the group that participated in a stress management program showed significantly fewer adverse cardiac events over a 5 year period than the men who received no stress education.
Both of these studies illustrate how important it is to manage our experience of stress. But of course, this is much easier said than done. If you feel you need some assistance in reducing your stress levels (and most of us probably do) you might check with local health institutions in your community. The Duke University Medical Center, for instance, has established the Duke Center for Integrative Medicine, offering consultation services and educational programs designed to promote optimum health through the integration of the health of the body with the health of the mind.
But what can you do to take control of stress right now? Three key habits can be an enormous help in controlling stress: eating nutritiously, getting the right amount of sleep, and sticking with a regular exercise program. (Again – all easier said than done.) It’s also important to recognize the things that trigger your stress. You might take a moment to sit down and make a list of the stress factors in your life. Another step that many find helpful is to talk about your stress with someone you trust. This is where a local health institution may be able to offer guidance.
Clearly, stress management can be an important element in any health regimen – and in fact may be one of the most positive things you can do to maintain your best possible health.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
