The Effects Of Stressful Life Situations on the Concentration of Blood Glucose In Diabetic and Nondiabetic Humans

Hinkle, Lawrence E.; Wolf, Stewart

doi:10.2337/diab.1.5.383

Cited by 53 publications

(11 citation statements)

References 7 publications

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“…The use of venous blood samples in conjunction with an indwelling needle has the advantages of good patient acceptability and a minimum of patient trauma (44)(45)(46). Although the differences between arterial and venous blood glucose levels are small under fasting conditions (arterial bloods average 9 mg. per 100 ml.…”

Section: Comparison Of Venous and Arterial Blood Samplesmentioning

confidence: 99%

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

Silverstone¹,

Brandfonbrener²,

Shock³

et al. 1957

J. Clin. Invest.

130

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In addition to providing information with regard to the status of carbohydrate metabolism, the time course of the disappearance of injected glucose from the blood stream offers information concerning the overall effectiveness of a variety of physiological mechanisms involved in maintaining homeostasis. In a number of investigations, reduction in glucose tolerance, i.e., a slower rate of return to fasting levels of blood sugar following the oral (1-17) or intravenous (18)(19)(20) administration of glucose, has been reported in older people. The diminished glucose tolerance in the older individual might be due to: (a) inadequate release of insulin from the pancreas, or greater inactivation of endogenously released insulin, (b) the loss of functioning protoplasm with increasing age so that less metabolizing tissue is removing glucose from the blood, (c) a diminution in the effectiveness of the metabolic processes involved in the removal of sugar from the blood stream, (d) alterations in the rate of release of glucose from the liver, or (e) a reduction in the volume in which the glucose is originally distributed in the aged. By comparing the glucose and glucose-insulin tolerance tests in the same individual, an estimate of the effect of insulin may be obtained (21)(22)(23)(24)(25)(26)(27). In the experiments to be reported, standard amounts of insulin were administered along with glucose to both old and young subjects with the aim of investigating age differences in the response to the insulin. Table I. Experimental procedure. The intravenous glucose tolerance test (GTT) and the glucose-insulin tolerance test (GITT) were performed in each subject under basal conditions and separated by an interval of not less than one week. In 8 of the subjects, each of the tests (GTT and GITT) was carried out twice in order to evaluate reliability.Twenty minutes before either test was begun, a modified Lindeman needle was placed in an antecubital vein and left in place for the duration of the test. The needle was kept patent by heparinization of the stylus and was used subsequently only for withdrawing blood specimens without a tourniquet (29). A vein in the opposite arm was used for the injection of 50 ml. of 50 per cent glucose in water over a period of two minutes. For the GITT, 5 units of hyperglycemic factor-free insulin8 (Lilly), per square meter of body surface area, were rapidly injected, followed immediately by the standard amount of glucose. The fasting blood specimen was obtained through the Lindeman needle a few minutes before zero time, which was recorded as the beginning of the injection of glucose.Blood samples were collected at 5-minute intervals for the first hour and at 20-minute intervals during the second hour, and were placed immediately in tubes containing a dried heparin and sodium fluoride mixture. All analyses were completed the day of the test, using the Nelson-Somogyi method (30). Determinations were in duplicate and were read on a Model DU Beckman Spectrophotometer.Data analysis. For each tolerance test...

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Section: Comparison Of Venous and Arterial Blood Samplesmentioning

confidence: 99%

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

Silverstone¹,

Brandfonbrener²,

Shock³

et al. 1957

J. Clin. Invest.

130

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“…Others have related the onset of diabetic illness specifically to coping difficulty in the face of stressful life events (12,13). Many reports assert that stress can cause both increased blood glucose and episodes of ketoacidosis (14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Marigo et al (24) and Weil and Sussman (25) claimed that specific kinds of stress correlated with glycosuria and acetonuria in summer camp diabetic chil-…”

mentioning

confidence: 98%

Stress and Metabolic Control in Diabetes: Psychosomatic Evidence and Evaluation of Methods

Barglow

Hatcher²,

Edidin³

et al. 1984

Psychosomatic Medicine

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Psychosomatic research findings correlating psychologic stress with diabetic control fail as yet to provide valid conclusions. Investigators have presented many contradictory findings. The two major pathways by which stress could affect control, a) changes in compliance behavior, and b) a neurohumoral axis, have not been clearly distinguished from each other. The study of adolescent cohorts is associated with the problem of heterogeneity, limiting the application of results to other diabetic populations. Methods of determining diabetic control have been incomplete and the definition and measurement of stress have major inadequacies for the analysis of such a complex psychosomatic problem. Existing evidence is comprehensively reviewed and evaluated. The authors use a modified definition of stress to construct a stress scale specific to pregnant diabetics.

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“…Chronic psychological stress has been associated with higher levels of glycosylated hemoglobin (A1C) (4 -6). In contrast, the effect of acute psychological stress on glucose concentrations in patients with type 1 diabetes is less conclusive, with most studies showing no effect and others resulting in increased or even decreased glucose concentrations (5,(7)(8)(9)(10)(11)(12)(13)(14)(15). In one previous study (5), the stress task was specifically applied in the postprandial state and was considered to have no effect, although the time course of glucose concentrations was altered.…”

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confidence: 99%

Acute Psychological Stress Affects Glucose Concentrations in Patients With Type 1 Diabetes Following Food Intake but not in the Fasting State

et al. 2005

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OBJECTIVE -To compare the effect of acute psychosocial stress on glucose concentrations in the fasting state and following food intake in patients with type 1 diabetes.RESEARCH DESIGN AND METHODS -In study 1, 20 patients were exposed to moderate psychosocial stress by means of the Trier Social Stress Test (TSST) in the fasting state. In study 2, the TSST was applied to 20 additional patients 75 min after intake of a standard meal. Glucose concentrations (by continuous glucose monitoring system), blood pressure, and heart rate were monitored on the control day and on the stress testing day.RESULTS -In both studies, blood pressure increased in response to TSST from 122/77 Ϯ 14/9 mmHg at baseline to a maximum of 152/93 Ϯ 21/13 mmHg (P Ͻ 0.001), and heart rate increased from 80 Ϯ 11 to 99 Ϯ 19 bpm (P Ͻ 0.001). In the fasting state (study 1), glucose concentrations remained unchanged during the control day as well as during the stress testing day. In study 2, glucose concentrations were similar on both days before and up to 75 min after the intake of the standard meal. However, a significant delay (of 45 min) in the decrease of glucose concentrations was induced by psychological stress. A two-factor repeated-measures ANOVA revealed a significant difference of glucose concentrations over time (F ϭ 646.65/P Ͻ 0.001).CONCLUSIONS -In the postprandial period, acute psychological stress induced a significantly delayed decrease of glucose concentrations, whereas in the fasting state, no effect on poststress glucose concentrations was observed. Diabetes Care 28:1910 -1915, 2005P atients with type 1 diabetes often complain of unexplained glucose excursions. Among other factors, variability in the absorption of insulin preparations and psychological stress may be of importance (2,3). Chronic psychological stress has been associated with higher levels of glycosylated hemoglobin (A1C) (4 -6). In contrast, the effect of acute psychological stress on glucose concentrations in patients with type 1 diabetes is less conclusive, with most studies showing no effect and others resulting in increased or even decreased glucose concentrations (5,7-15). In one previous study (5), the stress task was specifically applied in the postprandial state and was considered to have no effect, although the time course of glucose concentrations was altered. An additional study investigated patients on a glucose and insulin infusion in the fasting state. Since the insulin infusion rate was reduced at the beginning of the stress test, glucose concentrations were rising during the stress period, and an impaired insulin sensitivity following mental stress was found (15).A previous study (16) in healthy men showed a significantly more pronounced cortisol response to psychological stress following an oral glucose load compared with the cortisol response in the fasting state. Since an increase in cortisol levels in patients with type 1 diabetes may cause elevated glucose concentrations, the effect of acute psychological stress on glucose concentrations may cr...

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The Effects Of Stressful Life Situations on the Concentration of Blood Glucose In Diabetic and Nondiabetic Humans

Cited by 53 publications

References 7 publications

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

Stress and Metabolic Control in Diabetes: Psychosomatic Evidence and Evaluation of Methods

Acute Psychological Stress Affects Glucose Concentrations in Patients With Type 1 Diabetes Following Food Intake but not in the Fasting State

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