The Association of Cortisol Stress Response with Early Adversity and Diabetes Control in Adolescents with Diabetes

Daphne J Korczak,K Manassis

doi:10.4172/2167-1044.1000217

Abstract

1.1 Objectives: The hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the relationship between increased stress and poor diabetes control in children with type 1 diabetes mellitus (T1DM). The objectives of this study were two-fold: (1) To evaluate the effectiveness of the Trier Social Stress Test for Children (TSST-C) in inducing psychosocial stress in children with T1DM; (2) To investigate predictors of the cortisol stress response to the TSST-C. 1.2 Methods: Seventeen adolescents with T1DM were exposed to the TSST-C. Salivary cortisol was sampled pre-TSST-C and at six 10-minute intervals following the stress procedure. Measures of anxiety, depression, family functioning and early adversity were completed. 1.3 Results: The TSST-C induced a significant increase in cortisol response (p<.01). Early adversity predicted cortisol response to the stressor (p=.01). Early adversity was also associated with poorer diabetes control (p=.05). 1.4 Conclusion: The TSST-C was effective in producing a stress response in children with diabetes. Whereas previous research has emphasized psychological pathways which contribute to the relationship between psychosocial stressors and poor diabetes control, this study suggests that biological dysfunction may also underlie the association.

Highlights

Type 1 Diabetes Mellitus (T1DM) is associated with multiple sources of stress for affected youth and their families, with increased levels of stress associated with poorer diabetes control [1]
Based on previous research demonstrating the ability of a psychosocial stressor to elicit a cortisol response among children with a chronic inflammatory disorder, we hypothesized that the Trier Social Stress Task for Children (TSST-C [16,17]) would be an adequate stressor that causes a significant and reliable increase in cortisol levels among adolescents with T1DM
The first objective was to evaluate the ability of the Trier Social Stress Test for Children (TSST-C) to induce an adequate stress response among adolescents with T1DM

Summary

Conclusion

The TSST-C was effective in producing a stress response in children with diabetes. Whereas previous research has emphasized psychological pathways which contribute to the relationship between psychosocial stressors and poor diabetes control, this study suggests that biological dysfunction may underlie the association.

Introduction

Participants

Results

Discussion