Effect of the kobe earthquake on stress and glycemic control in patients with diabetes mellitus

Objectives: To examine the effects of the Kobe.Japan, earthquake a life-threatening event, on stress and glycemic control in diabetic patients. Patients and Methods: Hemoglobin A(1c) levels before and alter the earthquake were evaluated in diabetic patients in Kobe (N=157; magnitude, 7.2) and in Osaka, Japan. As a control (N=277; magnitude, 4.2),where little damage to houses and traffic facilities occurred. Glycosylated hemoglobin levels were also compared with those of 2 years before and 1 year after the earthquake. The General Health Questionnaire (GHQ) and a self-administered questionnaire regarding damage to houses and relatives killed or injured were used to assess psychological and mental stresses on earthquake survivors. Results: Glycemic control was aggravated in diabetic patients after the earthquake in Kobe but not in Osaka. The GHQ scores were significantly higher in the patients in Kobe than those in Osaka. Increased hemoglobin A(1c) concentrations and high scores on the GHQ were especially evident in diabetic patients with severe damage to houses and/or with relatives killed or injured. Conclusions: These results suggest an association between chronic, life-threatening stress and the worsening of metabolic control in patients with diabetes mellitus.