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Belastungen und Stress bei Typ‑1-Diabetes

Typ 1 diabetes-specific burden and distress

  • Leitthema
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Zusammenfassung

Seit langem ist bekannt, dass physiologischer Stress, kritische Lebensereignisse und psychosoziale Belastungen mit einer unzureichenden Qualität der Stoffwechseleinstellung bei Typ-1-Diabetes assoziiert sind. Die Richtung der Beziehungen ist bidirektional und wird durch physiologische und psychologische Prozesse, Verhalten und Umweltfaktoren determiniert. Diese Übersicht stellt über die Lebensspanne mit Typ-1-Diabetes dar, wie Stress sich direkt und indirekt auf den Glukosespiegel und das Therapieverhalten auswirken kann. Aber auch die Anforderungen einer modernen Diabetestherapie selbst können im Alltag erheblich fordern, besonders dann, wenn die Stoffwechseleinstellung – trotz großer Bemühungen – unbefriedigend bleibt. Der Eindruck geringer Selbstwirksamkeit in der Therapie kann, gekoppelt mit intensiven Ängsten vor akuten und langfristigen Komplikationen des Diabetes einen anhaltenden psychischen Stress darstellen und die Entwicklung einer depressiven oder Angststörung bahnen. Schließlich wird alltagspraktisch dargestellt, wie das Thema Stress in Patientenschulungen hilfreich vermittelt werden kann und welche allgemein anerkannten psychologischen Konzepte zur Stressreduktion sich auch bei Patienten mit Typ-1-Diabetes bewährt haben.

Abstract

It has been long known that physical stress, critical life events, and psychological burden are associated with insufficient glucose control in patients with type 1 diabetes. The relationship is bidirectional and is determined by physiological, psychological, behavioral, and environmental factors. In this paper, the direct and indirect impact of stress on glycemic control and patients’ therapeutic behavior is shown throughout the lifespan of type 1 diabetes patients. The requirements of current diabetes therapy in everyday life can be burdensome, particularly when glycemic control remains insufficient despite great efforts. The impression of low self-efficacy combined with fear of acute and long-term complications of diabetes might increase the risk of depression or anxiety disorder. Practical aspects of how the topic of stress can be taught in patient education courses and the practical implications in everyday life are presented. Moreover, established psychological interventions targeting the reduction of stress or stress reactions in general and among people with type 1 diabetes are presented.

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Authors and Affiliations

  1. Medizinische Psychologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    K. Lange &  G. Ernst

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  1. K. Lange
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  2. G. Ernst
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K. Lange und G. Ernst geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Lange, K., Ernst, G. Belastungen und Stress bei Typ‑1-Diabetes. Diabetologe 13, 554–561 (2017). https://doi.org/10.1007/s11428-017-0285-8

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  • DOI: https://doi.org/10.1007/s11428-017-0285-8

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