Griffith L S, Field B J, Lustman P J
Washington University School of Medicine, St. Louis, Missouri.
Int J Psychiatry Med. 1990;20(4):365-72. doi: 10.2190/APH4-YMBG-NVRL-VLWD.
The interrelationship of life stress, social support, and glucose regulation was studied in eighty patients with diabetes mellitus (insulin-dependent = 40, non-insulin-dependent = 40). Glucose control was measured using glycosylated hemoglobin (HbA1); stress and social support were determined by the Social Readjustment Rating Scale and a Visual Analog Scale of social support. A two-way analysis of variance [social support (high/low) by life stress (high/low)] revealed that neither social support nor life stress was independently associated with HbA1. However, a significant interaction between these parameters was found. When reported stress was low, the HbA1 means were not statistically different for both high and low social support groups. As stress increased, variations in social support were associated with differences in glucose control. Under conditions of high stress, low social support subjects had significantly higher HbA1 than subjects with high social support (mean = 11.8% vs. mean = 9.9%, p = .04). These data suggest that during stressful times social support may insulate patients with diabetes from the adverse physiologic and behavioral consequences of stress and thereby foster better glucose control.
对80例糖尿病患者（胰岛素依赖型40例，非胰岛素依赖型40例）的生活压力、社会支持和血糖调节之间的相互关系进行了研究。使用糖化血红蛋白（HbA1）来测量血糖控制情况；压力和社会支持通过社会再适应评定量表和社会支持视觉模拟量表来确定。一项双向方差分析[社会支持（高/低）×生活压力（高/低）]显示，社会支持和生活压力均与HbA1无独立相关性。然而，发现这些参数之间存在显著的交互作用。当报告的压力较低时，高社会支持组和低社会支持组的HbA1均值在统计学上无差异。随着压力增加，社会支持的差异与血糖控制的差异相关。在高压力条件下，低社会支持的受试者的HbA1显著高于高社会支持的受试者（均值分别为11.8%和9.9%，p = 0.04）。这些数据表明，在压力时期，社会支持可能使糖尿病患者免受压力带来的不良生理和行为后果的影响，从而促进更好的血糖控制。
