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Is Psychological Stress a Factor for Incorporation Into Future Closed-Loop Systems?
Linda A Gonder-Frederick1, Jesse H Grabman2, Boris Kovatchev3
1Center for Diabetes Technology, University of Virginia, Charlottesville, VA, USA Behavioral Medicine Center, University of Virginia, Charlottesville, VA, USA lag3g@virginia.edu.
Journal of Diabetes Science and Technology
|March 13, 2016
Summary
Daily psychological stress impacts blood glucose (BG) in type 1 diabetes (T1DM), increasing instability and hypoglycemia risk. Some individuals show greater metabolic reactivity to stress, suggesting personalized glucose control considerations.
Area of Science:
- Endocrinology
- Metabolic Health
- Diabetes Management
Background:
- The impact of daily psychological stress on blood glucose (BG) fluctuations in type 1 diabetes (T1DM) remains unclear.
- Research is needed to determine if stress-related BG changes warrant inclusion in glucose control algorithms.
Purpose of the Study:
- To examine the relationship between routine daily stressors and BG profile measures in individuals with T1DM.
- To investigate if psychological stress influences BG variability, hypoglycemia, and food consumption in a free-living environment.
Main Methods:
- 33 participants with T1DM using insulin pumps wore a continuous glucose monitoring (CGM) device for one week.
- Participants recorded daily psychological stress, carbohydrate intake, and insulin boluses.
Main Results:
- Daily stress was significantly associated with increased BG variability/instability (r = .172 to .185) and higher % time in hypoglycemia (r = .153).
- Increased stress correlated with decreased carbohydrate consumption (r = -.157).
- Individual differences in stressor impact on BG were observed, with models explaining more variance for highly stressed individuals.
Conclusions:
- Naturally occurring daily stressors are linked to increased glucose instability, hypoglycemia, and reduced food intake in T1DM.
- Findings suggest that some individuals are more metabolically reactive to stress.
- Further research with CGM is necessary to ascertain the clinical significance of daily stress on BG and its potential role in personalized glucose control systems.
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