A Study of Psychological Features in Patients With Type 2 Diabetes Mellitus

There is a lack of multidisciplinary studies examining the link between psychological factors and glycemic control in individuals with chronic illnesses. The aim of this study is to investigate the relationship between psychological factors such as resilience, perceived stress, emotional regulation, aggressiveness, and glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes. Additionally, the study seeks to determine the predictive value of perceived stress and resilience on HbA1c levels and to explore the role of anger expression and emotion regulation strategies in glycemic control, comparing diabetic patients to healthy controls.

The study was conducted between November 2021 and November 2023 at the Clinic of Endocrinology and Metabolic Diseases at the St. George University Hospital, Bulgaria, and the Department of Science and Research at the Medical University of Plovdiv, Bulgaria. Of these 84 individuals were diagnosed with type 2 diabetes, divided into two groups of 42 individuals each, who had poor and fair glycated hemoglobin. The third group was a healthy control consisting of 42 individuals in the same age group who had no established chronic diseases.

When comparing the study groups on HbA1c and individual psychological characteristics, there were statistically significant differences in resilience, perceived stress, emotion regulation suppression, and anger expression. When comparing the mean values of mental resilience with glycated hemoglobin levels, we find that there are statistically significantly higher mean values between the poor HbA1c control and the healthy group. From the regression analysis, we conclude that the psychological characteristics positively associated with perceived stress (β=0.502; p<0.001) and inversely associated with mental resilience (β=-0.359; p<0.001) are the most predictive. Less influential was the straight correlation with emotion regulation-expressive inhibition (β=0.226; p<0.05), the positive correlation with anger (β=0.170; p<0.001), and general aggressiveness (β=0.151; p<0.05).

From the present study, we note that glycated hemoglobin level is strongly influenced by two psychological predictors, namely subjective perception of stressful situations and resilience level.