The effects of acute psychological stress, heart rate variability (HRV), an indicator of autonomic function and glycemic variability (GV) have not been extensively researched in type 1 diabetes (T1D). The aim of this study is to explore the effect of acute psychosocial stress on HRV and GV in people with T1D. Methods: Eleven participants with T1D (33.00 ± 11.25 years) participated in the study. To assess acute mental stress, the subjects 1) participated in the Trier Social Stress Test (TSST); and 2) played competitive video games (Nintendo Switch™). The TSST followed standardized procedures whereby stress was induced asking participants to provide a job talk and arithmetic in front of two judges. Participants played the Mario Kart to go-kart races (10 minutes) and rotated their controllers to untangle the Treasure Chest (10 minutes). Resting HRV and GV were obtained. The subjects wore a continuous glucose monitor and a Zephyr Bioharness™ to record GV and HRV, respectively. Nonparametric, paired samples T-tests were conducted using SPSS 24.

Results: During TSST, there were significant differences between the resting and TSST testing period in the sympathetic nervous sympathetic nervous system index (.57 ± 1.33 vs. 1.36 ± 1.40; z = -2.845, respectively; p <.01; and stress index (8.17 ± 3.69 vs. 10.27 ± 5.69; z = -2.578, respectively; p <.05). When subjects were playing video games, there were significant differences in the parasympathetic nervous sympathetic nervous system index (-.09 ± 1.75 vs. -.87 ± 1.05; z = -2.134, respectively; p <.05) compared to a resting period. However, there were no significant differences in GV compared to a resting period in during TSST and playing video game.

Conclusion: This study suggests that the TSST induced stress in people with T1D, increased sympathetic activity; however, the TSST did not change glycemic variability. Playing competitive video game did not appear to neither induces stress nor affected glycemic variability. The competitive video game did not cause stress compared to TSST.


M. Park: None. Y. Song: None. M. Chu: None. M. Sevil: None. N. Hobbs: None. L. Sharp: None. A. Cinar: Research Support; Self; Dexcom, Inc., JDRF. Stock/Shareholder; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk A/S, Tandem Diabetes Care. L.T. Quinn: None.



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