The Relationship Between Stress and the Development of Diabetic Complications

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Abstract
Using the Life Events and Difficulties Schedule of Brown and Harris, the relationship between preceding stress and the onset of diabetic complications and premature death was investigated prospectively in a random sample of 130 patients with diabetes, aged 35-59 years. The presence of stress, assessed as severe life-events and severe long-term difficulties, was not significantly associated with premature death or the onset of macrovascular disease over the relatively short period of follow-up (4 years). Those who commenced anti-hypertensive therapy during the follow-up period were significantly more likely to have experienced five or more severe life-events during the previous 5 years (40 vs 6%, p less than 0.01), and also to have experienced one or more severe long-term difficulties during the same time period (60 vs 28%, p less than 0.05). A multiple Cox regression analysis showed that the effects of stress were independent of other factors such as baseline blood pressure, type of diabetes, sex, and ethnic group.