Psychological Stress and Metabolic Control in Patients with Type I Diabetes Mellitus

Abstract

Acute psychological stress is believed to cause disturbances of metabolic control in patients with Type I diabetes. To examine the validity of this assumption, we subjected nine healthy persons (mean [+/- SEM] blood glucose level, 74 +/- 2 mg per deciliter), nine patients with Type I diabetes who had normoglycemia (130 +/- 10 mg per deciliter), and nine diabetic patients with hyperglycemia (444 +/- 17 mg per deciliter) to two acute psychological stresses: mental arithmetic and public speaking. Subjects in the three groups were matched for age, weight, sex, and socioeconomic status. For all subjects, the mean increase in heart rate was 20 beats per minute while they were doing mental arithmetic and 25 beats per minute while they were speaking publicly (P less than 0.001). In all three groups, systolic and diastolic pressure rose markedly, the plasma epinephrine level increased by 50 to 150 pg per milliliter, and the norepinephrine level by 100 to 200 pg per milliliter under both stress conditions (P less than 0.001). The plasma cortisol level rose significantly after public speaking in all groups. Neither stress induced changes in circulating levels of glucose, ketones, free fatty acids, glucagon, or growth hormone. Thus, sudden, short-lived psychological stimuli causing marked cardiovascular responses and moderate elevations in plasma concentrations of catecholamines and cortisol are unlikely to disturb metabolic control in patients with Type I diabetes.

Neuroendocrine and Psychophysiologic Responses in PTSD: A Symptom Provocation Study

“…In contrast with previous symptom provocation studies in PTSD, we did find significant correlations between plasma epinephrine and norepinephrine levels both at baseline and in response to stimulation in all the subjects. When Epi and NE responses were studied in other paradigms, epinephrine was found to respond consistently to all types of stress-mental arithmetic, Stroop Test, public speaking, psychiatric examination, parachute jumping and traumatic films (Dimsdale et al 1987;Kaji et al 1989;Kemmer et al 1986;Richter et al 1996); whereas, NE responses were detected in fewer specific situations-public speaking, interview, and parachute jumping (Dimsdale et al 1987;Kemmer et al 1986;Richter et al 1996). In these studies, consistent with our findings, when a NE response was present, a significant correlation existed between Epi and NE responses.…”

Case Study: Infections in Diabetes Mellitus

“…Despite the well-defined pathophysiology of intercurrent illness and surgery on carbohydrate metabolism that may lead to hyperglycemia, many studies have also demonstrated that stress may result in diminished glucose values. [7][8][9][10][11][12][13][14][15][16][17][18][19] This reduction in glucose seen in times of stress is frequently attributed to insufficient administration of exogenous glucose.…”

Effect of 8 hours of hyperinsulinaemia on haemostatic parameters in healthy man

“…after centrifugation of 3 ml blood, 1.0 ml plasma and 1.0 ml of added 30% polyethylene glycol (tool 6000) were thoroughly mixed. After centrifugation the supernatant was stored at -20~ Plasma catecholamine and NEFA concentrations were assayed as described earlier by Kemmer et al [29].…”