Evidence of the role of psychosocial factors in diabetes mellitus: a review

Article Abstract:

Diabetes mellitus is a common disorder, but the psychological and sociological factors that may influence the course of this disease are frequently not taken into account. Some believe that psychosocial factors may actually cause diabetes, while others feel that only the physical factors are relevant in the treatment of this disorder. This article provides six perspectives with which to evaluate factors that may be relevant in diabetes; the framework may also be applied to other illnesses. These six research approaches rely upon anecdotal case reports; personality factors; epidemiological studies; studies of twins (to examine the extent of environmental versus genetic factors on disease development); artificially-induced (experimentally controlled) stress; psychosocial interventions (treatment such as psychotherapy, biofeedback, or psychotropic drugs); and basic science investigations. A variety of conflicting results are obtained using these different approaches, which points out the danger of relying exclusively upon only one avenue of investigation. A review of these findings provide helpful information for the primary care physician and the psychiatrist. For example, the psychiatrists treating a diabetic patient may be able to identify symptoms that are causing poor treatment compliance, and therefore leading to poor control over the diabetic condition. Evidence from studies of patients with chronic ulcerative colitis and breast cancer has indicated that psychiatric intervention may result in improvement of the physical condition of the patient; there is no reason to believe that this may not be true for diabetes and other physical illnesses as well. Better clinically controlled trials with large patient samplings that involve psychotherapeutic intervention are needed to determine the best overall therapeutic approach to diabetes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Diabetes research

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Alexithymic characteristics and metabolic control in diabetic and healthy adults

Article Abstract:

Alexithymia is characterized by difficulty in identifying and expressing emotions; a tendency to describe emotions in terms of physiological responses such as a rapid heartbeat rather than in terms of feelings or mental images; and an impoverished fantasy life. Since diabetes is believed to have psychological components as well as the physiological disorders, a study was conducted to examine indications of alexithymia in diabetic and healthy adults. The Thematic Apperception Test was used, in which the subject is asked to describe the events portrayed in an ambiguous drawing. In the analysis of the stories concocted by the patients to describe the pictures, words indicting emotions were counted. It was found that the diabetic patients were significantly less likely to use words that conveyed emotion. These results indicated that the diabetic patients were significantly more alexithymic than healthy subjects. The data also indicated that the diabetic patients who were achieving the poorest metabolic control, that is, those whose blood sugar levels were less likely to be close to normal values, also had the greatest levels of alexithymia. The authors suggest that the alexithymia among some diabetic patients may contribute to a poorer ability to manage their diabetic condition. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Diabetics, Metabolic regulation, Emotions, Alexithymia

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Identifying DNA transcription factors

Article Abstract:

The gel shift assay is used to examine the interaction between transcription factors and their DNA response elements. A small piece of DNA containing a response element of interest is labeled with a radioisotope. The probe is incubated in the presence of a tissue extract and the mixture is separated on a polyacrylamide gel. Antibodies directed against particular transcription factors can be added to the mixture before running the gel to determine the transcription factor responsible for binding the probe.

Methods, Genetic transcription, Transcription (Genetics), Assaying

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