Background: 90% of people with diabetes have stress, insomnia, decreased energy, temperature, appetite, weight, libido changes, and sympathetic/parasympathetic disturbance. These hypothalamic stress response disturbances result in impaired glucose control.Treating stress, sleep in short term studies(1-6 weeks) improves lifestyle, nutrition, exercise, and glucose control. Few studies have tested the hypothesis that improving stress will improve glucose control in long-term treatment.
Methods: We compared 80 stress-Rx adherent patients who achieved better sleep quality with 80 who did not. We recommend stress-Rx techniques four times daily like Benson’s relaxation exercises, deep breathing, meditation, and prayers. We quantified feeling of well-being, sleep duration extension, measured glucose control with AM insulin/glucose ratio, HgA1c, and in-target glucose when CGMS was available (16 patients). All patients followed our standard diabetes treatment protocol for type 2 including MIND nutrition plan and aerobic exercise 10 minutes after each meal (HIIT).
Results: At 12 months, adherents to Stress-Rx who achieved improved sleep improved the feeling of well-being by 78%, sleep increased 28 minutes, sleep onset latency decreased by 8 minutes. Insulin/glucose ratio was 16/133=0.12, HgA1c 7.1%, HgA1c<7 in 69%, and in-target glucose in 76% on CGMS (9 patients). On the other hand, in 80 patients who did not follow Stress-Rx and did not achieve improved sleep quality, feeling of well-being in 40%, sleep increased by 4 minutes,sleep onset latency decreased by 2 minutes. Insulin/Glucose ratio was 27/160=0.17, HgA1c 7.7%, HgA1c< 7 in 46%, and in-target-glucose in 58% on CGMS (7 patients.) Medications were 3 in both groups. Percentage needing basal insulin at the end was 8% in the good stress-Rx group, 16% in the non-improved sleep group.
Conclusion: Stress-Rx Improved insulin resistance with improved glucose control. Improved sleep, exercise, nutrition, and sympathetic outflow probably contributed 30%.
S. Sakkal: None.
