Depression, anxiety, stress can affect sugar control

Psychological factors can have a profound effect on the ability of diabetics to control their blood sugar, according to a recent study.1

Among diabetic patients who learned relaxation techniques with biofeedback, those with the highest levels of depression, anxiety, and daily stress were least successful in reducing their blood sugar. Investigators studied 18 adults with insulin-dependent diabetes, half of whom received medical care in addition to learning biofeedback-aided relaxation techniques. Half received only medical care. The patients who learned relaxation techniques were taught in 12 sessions, each lasting 45 minutes, and were encouraged to practice the techniques twice a day at home.

After four weeks, the researchers found no significant difference in blood sugar levels between those who received relaxation therapy and those who did not. However, they found that relaxation training did benefit patients who weren’t suffering from depression and anxiety. Among 12 patients who were not depressed, those who practiced relaxation techniques lowered their blood sugar levels about 9%, with no change in those who did not. Similarly, among nine patients who were not anxious, those who practiced relaxation techniques reduced their blood sugar levels by about 12%, with no change in those who did not.

"Subjects characterized by relatively high depression and anxiety scores took longer to complete the treatment protocol, which may be reflective of poorer adherence," wrote one of the investigators. She noted that other researchers have found that treatment with cognitive behavioral therapy or serotonin reuptake inhibitor antidepressants can improve mood and blood sugar control in diabetics with depression. The scientists plan to study the benefits of adding therapy or antidepressants to biofeedback and relaxation therapy in diabetes treatment.


1. McGrady A, Horner J. Role of mood in outcome of biofeedback-assisted relaxation therapy in insulin dependent diabetes mellitus. Appl Psychophysiol Biofeedback 1999; 24:79-88.