Impact of Psychological Stress caused by the Great East Japan Earthquake on Glycemic Control in Patients with Diabetes

 

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Abstract

We examined the relationship between psychological stress and the worsening of glycemic control in diabetic patients at the time of the Great East Japan Earthquake. HbA1c levels in diabetic patients before and after the disaster were evaluated with the General Health Questionnaire (GHQ) and other questions including those on changes in diet, exercise, psychological stress and drug intake in 320 consecutive diabetic patients who had been followed in a diabetes clinic. Logistic regression analysis revealed that the total GHQ scores (odds ratio [OR] 1.03 [95% confidence interval 1.01–1.06]; p<0.01) and interruption of drug intake (OR 4.48 [1.57–12.7]; p=0.01) were independently associated with worsening of glycemic control defined as an increase in the HbA1c level equal to or greater than 0.5%. Among the scores on the GHQ, those for somatic symptoms (OR 1.18 [1.01–1.38]; p=0.03) and sleep disturbances or anxiety (OR 1.26 [1.08–1.46]; p<0.01) were independently associated with glycemic control. These results suggest that psychological stress during a disaster has independent effects on worsening of glycemic control.

• References

• 1 Kirizuka K, Nishizaki H, Kohriyama K et al. Influences of The Great Hanshin-Awaji Earthquake on glycemic control in diabetic patients. Diabetes Res Clin Pract 1997; 36: 193-196
  CrossrefPubMedGoogle Scholar
• 2 Ng J, Atkin SL, Rigby AS et al. The effect of extensive flooding in Hull on the glycaemic control of patients with diabetes. Diabet Med 2011; 28: 519-524
  PubMedGoogle Scholar
• 3 Fonseca VA, Smith H, Kuhadiya N et al. Impact of a natural disaster on diabetes: exacerbation of disparities and long-term consequences. Diabetes Care 2009; 32: 1632-1638
  CrossrefPubMedGoogle Scholar
• 4 American Diabetes Association . Statement on Emergency and Disaster Preparedness: a report of the Disaster Response Task Force. Diabetes Care 2007; 30: 2395-2398
  CrossrefPubMedGoogle Scholar
• 5 Sengul A, Ozer E, Salman S et al. Lessons learnt from influences of the Marmara earthquake on glycemic control and quality of life in people with type 1 diabetes. Endocr J 2004; 51: 407-414
  CrossrefPubMedGoogle Scholar
• 6 Berggren RE, Curiel TJ. After the storm – health care infrastructure in post-Katrina New Orleans. N Engl J Med 2006; 354: 1549-1552
  CrossrefPubMedGoogle Scholar
• 7 Cefalu WT, Smith SR, Blonde L et al. The Hurricane Katrina aftermath and its impact on diabetes care: observations from “ground zero”: lessons in disaster preparedness of people with diabetes. Diabetes Care 2006; 29: 158-160
  CrossrefPubMedGoogle Scholar
• 8 Simons M, Minson SE, Sladen A et al. The 2011 magnitude 9.0 Tohoku-Oki earthquake: mosaicking the megathrust from seconds to centuries. Science 2011; 332: 1421-1425
  CrossrefPubMedGoogle Scholar
• 9 The Committee of Japan Diabetes Society on the diagnostic criteria of diabetes mellitus . Report of the Committee on the classification and diagnostic criteria of diabetes mellitus J Japan Diab Soc 2010; 53: 450-467
  PubMed
• 10 Goldberg DP, Blackwell B. Psychiatric illness in general practice. A detailed study using a new method of case identification. Br Med J 1970; 1: 439-443
  PubMedGoogle Scholar
• 11 Medina-Mora ME, Padilla GP, Campillo-Serrano C et al. The factor structure of the GHQ: a scaled version for a hospital’s general practice service in Mexico. Psychol Med 1983; 13: 355-361
  CrossrefPubMedGoogle Scholar
• 12 Inui A, Kitaoka H, Majima M et al. Effect of the Kobe earthquake on stress and glycemic control in patients with diabetes mellitus. Arch Intern Med 1998; 158: 274-278
  CrossrefPubMedGoogle Scholar
• 13 Bland SH, O’Leary ES, Farinaro E et al. Long-term psychological effects of natural disasters. Psychosom Med 1996; 58: 18-24
  CrossrefPubMedGoogle Scholar