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Is Psychological Stress a Factor for Incorporation Into Future Closed-Loop Systems?

Authors :
Gonder-Frederick LA
Grabman JH
Kovatchev B
Brown SA
Patek S
Basu A
Pinsker JE
Kudva YC
Wakeman CA
Dassau E
Cobelli C
Zisser HC
Doyle FJ 3rd
Source :
Journal of diabetes science and technology [J Diabetes Sci Technol] 2016 May 03; Vol. 10 (3), pp. 640-6. Date of Electronic Publication: 2016 May 03 (Print Publication: 2016).
Publication Year :
2016

Abstract

Background: The relationship between daily psychological stress and BG fluctuations in type 1 diabetes (T1DM) is unclear. More research is needed to determine if stress-related BG changes should be considered in glucose control algorithms. This study in the usual free-living environment examined relationships among routine daily stressors and BG profile measures generated from CGM readings.<br />Methods: A total of 33 participants with T1DM on insulin pumps wore a CGM device for 1 week and recorded daily ratings of psychological stress, carbohydrates, and insulin boluses.<br />Results: Within-subjects ANCOVAs found a significant relationship between daily stress and indices of BG variability/instability (r = .172 to .185, P = .011 to .018, r(2) = 2.97% to 3.43%), increased % time in hypoglycemia (r = .153, P = .036, r(2) = 2.33%) and decreased carbohydrate consumption (r = -.157, P = .031, r(2) = 2.47%). Models accounted for more variance for individuals reporting the highest daily stress. There was no relationship between stress and mean daily glucose or low/high glucose risk indices.<br />Conclusions: These preliminary findings suggest that naturally occurring daily stressors can be associated with increased glucose instability and hypoglycemia, as well as decreased food consumption. In addition, findings support the hypothesis that some individuals are more metabolically reactive to stress. More rigorous studies using CGM technology are needed to understand whether the impact of daily stress on BG is clinically meaningful and if it is a behavioral factor that should be considered in glucose control systems for some individuals.<br />Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: LAGF has been a consultant for, received research funding/support from, and/or served on advisory boards for Abbot Laboratories, AstraZeneca plc, Dexcom Inc, Johnson & Johnson Services Inc, and/or Merck & Co Inc. BK, SAB, and CC have received research support/funding from Dexcom Inc and Roche Diagnostics. BK and SP report patents/patent applications related to glycemic control in diabetes managed by the University of Virginia Licensing and Ventures group and holding shares in TypeZero Technologies. ED and FJD report grants from JDRF and NIH during conduct of the study; algorithms licensing by Animas Corporation and mod AGC. BK reports additional research support/funding from Sanofi-Aventis, BD, and Tandem Diabetes Care; advisory panel/consulting for AstraZeneca plc, BD, and Inspark Technologies. SAB has received additional research support/funding from LifeScan, Animas, and ConAgra. SP has received research funding/support from Eli Lilly. HCZ is currently an employee of Insulet Corporation.<br /> (© 2016 Diabetes Technology Society.)

Details

Language :
English
ISSN :
1932-2968
Volume :
10
Issue :
3
Database :
MEDLINE
Journal :
Journal of diabetes science and technology
Publication Type :
Academic Journal
Accession number :
26969142
Full Text :
https://doi.org/10.1177/1932296816635199