Juvenile diabetes patients maintain good control over their blood sugar

NEW YORK, June 15: Most patients with type 1 diabetes, also known as juvenile diabetes, maintain good control over their blood sugar, without having to adjusting their insulin dose when they are exposed to short-term mental stress - in this case -- a rollercoaster ride -- Swiss investigators report.

Diabetes patients are often confronted with questions about the affects of psychological stress on blood sugar -- chronic psychosocial stress has been associated with increased blood sugar and poor adherence to treatment, Dr Peter Wiesli, of University Hospital of Zurich, and colleagues write in the journal Diabetes Care.

To investigate the effects of short-term mental stress, the researchers asked 20 type 1 diabetic patients to monitor their sugar levels while they were riding on two different rollercoasters within 15 minutes.

The subjects' blood pressure, heart rate, and levels of salivary cortisol, a hormone secreted in response to stress, were monitored the day before, without stress, and on the stress-testing day. The Medtronic MiniMed continuous glucose monitoring system was used to monitor blood sugar concentrations in 5-minute intervals.

Half the participants rode the rollercoasters in a fasting state while the others did so 75 minutes after they had a standard meal containing 50 grams of carbohydrates.

''During the rides, heart rate rose from 82 beats per minute at the start of the ride up to a maximum of 158 beats per minute,'' Wiesli's team reports. The average blood pressures increased from 124/79 to 160/96 mm Hg between the two rides, and salivary cortisol concentrations increased from 6.3 to a maximum of 19.3 nanomoles per liter per 60 minutes after the ride.

Despite the evident stress, the investigators report that glucose concentrations were not significantly different during the control period (6.2 millimoles per liter) and stress-testing period (6.7 millimoles per liter) in the 10 patients investigated in the fasting state. For the other 10 patients, sugar levels similarly increased in response to the meal on the control and the stress-testing day, and returned to normal within 3 hours of the meal.

Severe, short-lived mental stress had little effect on blood sugar control in type 1 diabetes patients, the investigators conclude. However, they point out that the subjects in this experiment had fairly good metabolic control over their disease. The results might not be the same forpatients facing short-term or chronic mental stress, but havepoor control over their blood sugar.

Reuters>