Stress and adherence

“Stress and emotional problems are also correlated with adherence. Fewer minor stressors were associated with higher levels of adherence to insulin administration and diet in women with gestational diabetes (56,68). In a study using a diabetes-specific stress scale in a combined sample of adults with type 1 and type 2 diabetes (69), stress was found to be significantly associated with two aspects of the diet regimen (diet amount and diet type). However, no associations were found between stress and adherence to physical activity regimens or glucose testing in this sample. Peyrot et al. (70) reported that psychosocial stress was associated with poor adherence to a prescribed regimen and poor metabolic control in a mixed group of patients with type 1 and type 2 diabetes. Mollema et al. (71) reported that patients who had an extreme fear of insulin injections or self-monitoring of blood glucose had lower levels of adherence and higher levels of emotional distress. Schlundt, Stetson & Plant (72) grouped patients with type 1 diabetes according to the problems they encountered in adhering to prescribed diets and found that two of the groups of patients – emotional eaters and diet-bingers – had adherence problems related to negative emotions such as stress and depression.”

WHO, 2003

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