Ahola Aila J, Forsblom Carol, Harjutsalo Valma, Groop Per-Henrik
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Abdominal Center, Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
J Diabetes Res. 2020 Jul 18;2020:3548520. doi: 10.1155/2020/3548520. eCollection 2020.
Stress may negatively impact self-management of diabetes and thereby deteriorate glycaemic control. Eating is the most frequently reported stress-release method. In this study, we investigated the association between perceived stress (PS), dietary adherence, and glycaemic control. Data from participants in the FinnDiane Study with type 1 diabetes who had completed a diet questionnaire and Cohen's perceived stress scale (PSS) were included. In addition to using a continuous PSS score, participants were divided into three groups based on the PSS scores: the first PSS quartile, low levels of PS; second and third quartiles, moderate levels of PS; and fourth quartile, high levels of PS. A diet score reflecting the level of adherence to dietary recommendations was calculated. Analyses were conducted in the whole sample and in subgroups divided by body mass index (BMI < 25 kg/m vs. BMI ≥ 25 kg/m). In the whole sample, high PS and continuous stress score were negatively associated with the diet score and with adherence to fish, fresh vegetable, low-fat liquid milk product, and vegetable oil-based cooking fat recommendations. The stress score was negatively associated with the diet score both in lean and in those overweight or obese. However, fish and fresh vegetable recommendations were only affected in those with corpulence. PS was not associated with mean blood glucose concentrations in the whole sample. When divided by BMI status, worse glycaemic control was observed in lean subjects reporting stress. In individuals with overweight or obesity, instead, high glucose concentrations were observed regardless of the level of perceived stress. Interventions to improve stress management could improve dietary adherence and glycaemic control and could thereby have the potential to improve long-term health and well-being of individuals with type 1 diabetes.
压力可能会对糖尿病的自我管理产生负面影响，从而使血糖控制恶化。饮食是最常被提及的减压方式。在本研究中，我们调查了感知压力（PS）、饮食依从性和血糖控制之间的关联。纳入了芬兰糖尿病研究中完成饮食问卷和科恩感知压力量表（PSS）的1型糖尿病参与者的数据。除了使用连续的PSS评分外，参与者还根据PSS评分分为三组：第一个PSS四分位数，低水平的PS；第二和第三个四分位数，中等水平的PS；以及第四个四分位数，高水平的PS。计算了反映饮食建议依从水平的饮食评分。在整个样本以及按体重指数（BMI < 25 kg/m² 与 BMI ≥ 25 kg/m²）划分的亚组中进行了分析。在整个样本中，高PS和连续压力评分与饮食评分以及对鱼类、新鲜蔬菜、低脂液态奶制品和植物油烹饪脂肪建议的依从性呈负相关。压力评分在瘦者以及超重或肥胖者中均与饮食评分呈负相关。然而，鱼类和新鲜蔬菜建议仅在肥胖者中受到影响。PS与整个样本中的平均血糖浓度无关。按BMI状态划分时，报告有压力的瘦者血糖控制较差。相反，在超重或肥胖个体中，无论感知压力水平如何，均观察到高血糖浓度。改善压力管理的干预措施可以提高饮食依从性和血糖控制，从而有可能改善1型糖尿病患者的长期健康和幸福感。
