Stress and Coping among African Americans at Risk for Type 2 Diabetes Mellitus

Background: There are substantial racial/ethnic disparities in risk of type 2 diabetes mellitus (T2DM), and it is hypothesized that social stress contributes to these disparities. However, the dynamic biological and psychological processes linking T2DM and emotional distress are not well understood. Objective: We describe the results of the Stress and Sugar Study (SASS), an ongoing pilot study of stress and coping among African Americans with pre-diabetes. The aim of this study is to understand the influence of social stressors on health behaviors, coping, and hyperglycemia. Results: Among 25 participants recruited to date (Mean age: 57, 87% female, 74% with a high school education or less), the most frequent self-reported chronic stressors were finances, poor health, and unemployment. Number of stress symptoms were positively correlated with depressive symptoms (r2=.64, p<0.001), frequency of eating sweet foods (r2=0.51, p<0.02), fried foods (r2=0.47, p<0.03), and larger amounts of food than normal (r2=49, p<0.001) as a means to cope with stress.  Negative cognitive coping processes (e.g., blaming oneself, avoidant coping) were positively associated with HBA1c (r2=.50, p<.019; r2=.48, p<.025, respectively) and body mass index (r2=.48, p<.02; r2=.46, p<.026, respectively Conclusions: Results indicate that coping with social stressors are related with T2DM risk behaviors as well as clinical measures among populations at high-risk of T2DM.  These findings have important implications for efforts aimed at reducing social disparities in T2DM.