Abstract
Stress is associated with a variety of physical and psychological health variables. Two potential pathways may mediate this relationship: physiological changes and changes in behavior. In addition, social support may buffer the relationship between stress and health, particularly in women. Among adults with Diabetes Mellitus, some studies demonstrate a significant association between stress and metabolic variables, whereas others have found no support for a relationship. Many of the studies included different diagnostic categories or different age groups; furthermore, few have included a measure of adherence which may act as a mediator between stress and disease control. The present study examined the relationship between stress and metabolic control in adults with Insulin-Dependent Diabetes Mellitus (IDDM), as well as the potential mediating effects of adherence, and the potential moderating effects of social support in women. Seventy-four adults (38 women and 36 men) completed the Perceived Stress Scale, Interpersonal Support Evaluation List, and Self Care Inventory. Measures of glycosolated hemoglobin were obtained. The results indicated that stress was not associated with metabolic control (r =.03) in this group of subjects who were generally in good metabolic control (mean HbA1c = 7.2%). There was no evidence for mediating effects of adherence, nor for buffering effects of social support in women. Stress was associated with lower levels of adherence, and lower levels of adherence were associated with worse metabolic control in women, but not in men. Multiple regression analysis revealed that in women, adherence accounted for 12% of the variance in metabolic control. Age and level of perceived stress accounted for 14% of the variance in adherence. Social support was not associated with either degree of metabolic control nor level of adherence, but was inversely related to level of perceived stress. Older women reported higher levels of adherence, but lower levels of social support. The results suggest that stress is not associated with poor metabolic control in adults with IDDM whose diabetes is well-controlled. Limitations of the study, as well as directions for future research are presented.