The effect of perceived stress on glycated hemoglobin value (HbA1c) on Diabetes type 2 patients- An observational study from Lahore, Pakistan

Abstract

Introduction: Diabetes mellitus (type 2) is a common endocrine disease characterized by elevated blood glucose levels. Various sociodemographic, environmental factors and clinical predictors positively influence blood glucose levels in diabetics. The study investigates the link between stress levels as determined by the Perceived Stress Scale (PSS-10) and HbA1c levels which is used as an indicator of long-term blood glucose control. The aim of this study is to evaluate the correlation between perceived stress and glycemic regulation in individuals diagnosed with Type 2 diabetes-mellitus. Methodology: A cross-sectional observational study was conducted to evaluate the association between perceived stress and glycemic control in Type 2 diabetes mellitus patients. A total of 151 patients from Lahore, Punjab were selected for this study. Glycated hemoglobin level (HbA1c) of the patients were recorded on a data collection form along with demographic information. While, the tool used to access stress levels in patients was: Perceives stress scale (PSS-10). Patients visiting endocrinology clinics were recruited in the study upon providing informed consent. Results: Majority of the patients were female (53.6%) belonging to the age group 41-50 years of age (35.8%). The average HbA1c value observed was 8.70 ±1.99 (M±SD). The study of the population showed that (57.6%) of participants experienced high stress levels while (39.1%) showed moderate stress and (3.3%) reported low stress. The respondents experiencing high stress were more susceptible to having poor HbA1c levels, indicating a significant correlation between stress and hyperglycemia (p-value<0.001). The recently diagnosed patients with the history of diabetes from past 1-2 years presented maximum stress levels (53.8%). Commons Attribution License 4.0 (CC BY 4.0)., which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. DISCOVERY SCIENTIFIC SOCIETY ARTICLE | OPEN ACCESS Medical Science 29, e21ms3512 (2025) 2 of 10 in T2DM patients as the results showed a significant correlation between perceived stress levels and HbA1c, but the association of sociodemographic variables with perceived stress was not observed to be significant. The results recommends that stress management (stress management techniques or relaxation techniques) should be considered along with medical intervention for diabetic patients to achieve the desired outcome of the patients.