Higher Perceived Stress and Poor Glycemic Changes in Prediabetics and Diabetics Among Indian Population

Abstract

Diabetes mellitus (DM) is a chronic metabolic disorder with significant co-morbidities and healthcare burdens. Many large studies have investigated the association between perceived stress and DM; however, none investigated this in a larger Indian population. We hypothesized stress as one of the reasons for the progression of people with prediabetes into DM. The present study was, therefore, planned to report on associations between perceived stress and blood glucose markers stratified by diabetic status. The current descriptive study was a subset analysis of the nationwide cross-sectional survey, conducted in all Indian zones under the National Multicentric Diabetes Control Program. The study examined the perceived stress levels using a perceived stress scale (PSS-10) in people with prediabetes (n=649) and DM (n=485) and then segregated them into three categories (minimum, moderate, and severe). Blood glucose markers (fasting blood glucose, postprandial blood glucose, and HbA1c) were evaluated to report their association with the perceived stress. The study revealed a significantly higher HbA1c level in people with prediabetes, particularly those with severe perceived stress (6.12 ± 0.27) compared to other categories. Those with DM had a higher fasting blood glucose level, particularly with severe perceived stress (239.28 ± 99.52). An increased HbA1c level is noted in severely stressed people with prediabetes, requiring a comprehensive analysis with a longitudinal study of the role of perceived stress in the progression of prediabetes into DM. Additionally, higher fasting blood glucose levels in patients with DM and severe perceived stress suggests the need for establishing comprehensive diabetic care inclusive of stress management.

Keywords: CCRYN (Central Council of Research in Yoga and Naturopathy, New Delhi); DM (Diabetes mellitus); Diabetes mellitus; FBS (fasting blood sugar); HPA (hypothalamic-pituitary-adrenal axis); HbA1c; HbA1c (glycated hemoglobin); IDRS (Indian Diabetes Risk score); IYN (Indian Yoga Association); NMB (Niyantrita Madhumeha Bharata Abhiyaan); PPBS (postprandial blood sugar); PSS (Perceived Stress Scale); WHO (World Health Organization); perceived stress; prediabetes.