Objective: There have been no clear data describing the association between acute psychological stress and glycemic variability (GV) in people with type 1 diabetes (T1D). Patients self-report that acute stress leads to hyperglycemia.

Methods: Twenty adults with T1D on CGM augmented insulin pump completed self-reported psychological stress diaries for a period of 5 weeks at 2 clinical research centers. Participants reported intensity of stress on a 7-point scale, with 1 indicating mild stress and 7 severe stress, and duration of each stress episode. CGM data were analyzed for week 1 and week 5.

Results: Baseline characteristics were age 44.9±15.0 years, F/M 12/8, HbA1c 6.8±0.7%, and diabetes duration 22.9±15.9 years. Total number of stress events reported was 126 over the two-week period. Subjects reported stress on average of 9±2.2 days representing 64.2%±28.2% of days. GV was compared on days of stress vs. days without stress for each subject. Mean BG did not differ; however, % time spent above 250 mg/dl was less in patients who did not report stress events during the day (6.1± 9.8%) compared to patients with stressful episodes (10.1±17.6%) (p=0.02) (Table).

Discussion: Acute stress in patients with T1D was associated with certain measures of GV. We are currently analyzing GV based on duration and intensity of stress and the time between reported stress and change in glucose.

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Disclosure

V. Dadlani: None. J.E. Pinsker: Research Support; Self; Ascensia Diabetes Care, Dexcom, Inc., Insulet Corporation, LifeScan, Inc., Roche Diabetes Care, Tandem Diabetes Care. Speaker's Bureau; Self; Tandem Diabetes Care. K. Kumari: None. C.C. Andre: None. M. Cescon: None. C. Reid: None. S.K. McCrady-Spitzer: None. P. Thapa: None. M. Church: None. D. Choudhary: None. F.J. Doyle: Consultant; Self; ModeAGC. Other Relationship; Self; Insulet Corporation. E. Dassau: Consultant; Self; Eli Lilly and Company, Insulet Corporation. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Ltd., Insulet Corporation, Roche Diabetes Care, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker's Bureau; Self; Roche Diabetes Care. Other Relationship; Self; ModAGC. Y.C. Kudva: Advisory Panel; Self; Novo Nordisk Inc. Other Relationship; Self; Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care.

Funding

JDRF; The Leona M. and Harry B. Helmsley Charitable Trust (2-SRA-2017-503-M-B); Dexcom, Inc. (IIS-2017-043)

© 2019 by the American Diabetes Association.
2019
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