Vulnerability to stress, anxiety and depressive symptoms and metabolic control in Type 2 diabetes

Background: Vulnerability to stress has been associated to distress, emotional distress symptoms and metabolic control in type 2 diabetes mellitus (T2DM) patients as well. Furthermore some conflicting results were noticed. We aimed to evaluate the effect over metabolic control in what concerns vulnerability to stress beyond depressive and anxiety symptoms. Findings. This cross-sectional study assessed 273 T2DM patients with depressive and anxiety symptoms using the Hospital Anxiety Depression Scale (HADS) and the 23 Questions to assess Vulnerability to Stress (23QVS), along with demographic and clinical diabetes-related variables. Hierarchical logistic regression models were used to investigate predictors of poor glycemic control. The results showed an association of depressive symptoms (odds ratio=1.12, 95%CI=1.01-1.24, P=0.030) with increased risk of poor glycemic control. Anxiety symptoms and vulnerability to stress on their own were not predictive of metabolic control, respectively (odds ratio=0.92, 95%CI=0.84-1.00, P=0.187 and odds ratio=0.98, 95%CI=0.95-1.01, P=0.282). Conclusions: Our data suggested that vulnerability to stress was not predictive of poor glycemic control in T2DM, but depressive symptoms were.