NEW YORK (Reuters Health) - Programs that help people with diabetes to manage stress can help lower blood sugar levels and may eventually reduce the risk of medical complications such as kidney disease and blindness, according to a study released Thursday.

The report of 72 adults with type 2 diabetes found that those who participated in just 5 sessions of group stress management therapy reduced their long-term blood sugar (glucose) by an average of 0.5%--equal to the effect seen with some drugs. Nearly one third of patients who received stress management lowered their blood glucose levels by 1%, compared with 12% of diabetics who did not participate in the sessions.

According to the authors, reducing blood glucose by as little as 0.5% may translate into a lower risk of diabetes-related medical complications. Earlier studies had shown that intensive, one-on-one stress management sessions can help diabetics to control their blood sugar, and this study is the first to show that a group approach can work as well, according to the report.

``Patients with type 2 diabetes should be aware that stress can negatively impact on glucose control. They might want to try learning stress management either in a clinical setting or through a self-help approach,'' Dr. Richard Surwit, the study's lead author, told Reuters Health.

The results are published in the January issue of Diabetes Care.

The study included patients at least 30 years old who managed their diabetes through a combination of diet, exercise and oral medication. Individuals who were receiving therapy and those who had participated in other previous relaxation or stress management training were excluded.

The 38 patients in the stress management program learned muscle relaxation techniques and ways to recognize and reduce stress through deep breathing or guided imagery. Instructors encouraged participants to practice the techniques on their own at home and talked about the health consequences of stress.

As a ``control'' group, 34 patients received general diabetes education, including information about symptoms, complications, nutrition and treatment.

After 1 year, patients who received stress management had lower glucose levels while those in the control group showed slightly higher blood glucose levels, report researchers. Their study found no significant changes in diet and exercise habits, suggesting that these lifestyle factors did not contribute to the lower blood sugar levels seen in adults participating in stress management sessions.

Patients who were the most anxious before the study began did not benefit any more than those who were only mildly stressed, the study found.

``This study...suggests that stress management can be a meaningful addition to a comprehensive treatment program for patients with type 2 diabetes,'' concludes the team of researchers from Duke University in Durham, North Carolina.

Surwit said that future studies should examine whether audio or videotapes are an effective way of learning stress management.

``Given the cost-consciousness of American health care, even a relatively inexpensive group therapy approach might be considered too costly. However, if one compares the cost of our intervention with that of a year's worth of some medication which might be added to what a patient is currently taking, I believe that our approach would be less expensive,'' he said.

SOURCE: Diabetes Care 2002;25:30-34.

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