Biofeedback Relaxation Control of Diabetes

McGrady, Angele

Abstract

Type I insulin dependent diabetes mellitus (IDDM) has been described as the most psychologically and behaviorally demanding of the chronic medical illnesses. Patients must learn new skills, modify their lifestyle and be motivated to maintain vigilance of their blood glucose. Furthermore, stressful life events as well as minor daily hassles often interfere with stable blood glucose levels. During stress, catecholamines and cortisol are released to produce hyperglycemia and an increased requirement for insulin. Over time, insulin resistance and secondary complications of the disease develop. Stress management including biofeedback and relaxation training has the potential to assist patients with Type I IDDM in decreasing the hyperglycemia produced during and after stress. Although biofeedback assisted relaxation has been tested as an alternative or adjunctive treatment in other medical illnesses and the potential benefits to patients with diabetes are significant, stress management has not been incorporated in traditional care of patients with Type I IDDM. Thus, we propose in a repeated measures controlled study to test the efficacy of biofeedback-assisted relaxation as an alternate to increasing insulin dosage under stressful conditions. Data from four sampling periods will be analyzed. These are: the pretreatment period, the period after diabetes education and one and three months after biofeedback-assisted relaxation treatment. Self report of blood glucose will be confirmed by biologic assay, specifically glycosylated hemoglobin and fructosamine. Measures of anxiety and daily hassles will be correlated with blood glucose values. After the completion of this pilot study, our longer term objectives include a full scale efficacy study and the development of a program to ensure that stress management is incorporated as a routine part of traditional management of diabetes.