Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, Zurich, Switzerland.
Diabet Med. 2012 Jan;29(1):128-31. doi: 10.1111/j.1464-5491.2011.03431.x.
To investigate the effect of acute psychological stress on glucose concentrations in patients with Type 2 diabetes, in the fasting state as well as in the postprandial state.
Thirty patients (12 female) with Type 2 diabetes were included. Mean ± SD age was 60 ± 12 years, BMI 28.8 ± 4.2 kg/m(2), diabetes duration 8.9 ± 6.7 years and HbA(1c) 51 ± 9 mmol/mol (6.8 ± 0.8%). Using a non-randomized approach, all participants were exposed to moderate psychological stress by means of the Trier Social Stress Test: 10 participants in the fasting state and 20 participants 75 min after intake of a standard meal. Blood pressure, heart rate and salivary cortisol were monitored on the control day and the stress-test day. Glucose concentrations were assessed using a continuous glucose monitoring system.
On the stress-test day, blood pressure rose from 117/73 ± 13/12 to 155/92 ± 22/14 mmHg, heart rate from 77 ± 11 to 91 ± 25 b min(-1) and salivary cortisol concentrations from 8.5 ± 3.7 to 26.4 ± 12.1 nmol/l (P < 0.001); these measurements remained unchanged on the control day. On the stress-test day, when the Trier Social Stress Test was applied 75 min after the intake of a standard meal, the glucose concentrations were significantly higher compared with the control day (mean difference 1.5 mmol/l, 95% CI 0.5-2.4, P = 0.003). In the fasting state, glucose concentrations slightly decreased during the control day but remained stable on the stress-test day (mean difference compared with the control day 0.7 mmol/l, 95% CI -0.7 to 2.0, P = 0.31).
When stress is experienced in the postprandial period, acute psychological stress significantly increases glucose concentrations in patients with Type 2 diabetes.
研究急性心理应激对 2 型糖尿病患者空腹和餐后血糖浓度的影响。
纳入 30 例（12 名女性）2 型糖尿病患者。平均年龄为 60 ± 12 岁，BMI 为 28.8 ± 4.2 kg/m(2)，糖尿病病程为 8.9 ± 6.7 年，HbA(1c)为 51 ± 9 mmol/mol（6.8 ± 0.8%）。采用非随机方法，所有患者均通过特里尔社会应激测试（Trier Social Stress Test）经历中度心理应激：10 例在空腹状态下，20 例在标准餐摄入后 75 分钟时。在对照日和应激测试日监测血压、心率和唾液皮质醇。使用连续血糖监测系统评估血糖浓度。
在应激测试日，血压从 117/73 ± 13/12 升至 155/92 ± 22/14 mmHg，心率从 77 ± 11 升至 91 ± 25 b min(-1)，唾液皮质醇浓度从 8.5 ± 3.7 升至 26.4 ± 12.1 nmol/l（P < 0.001）；这些指标在对照日没有变化。在应激测试日，当在标准餐摄入后 75 分钟进行特里尔社会应激测试时，血糖浓度与对照日相比显著升高（平均差值 1.5 mmol/l，95%CI 0.5-2.4，P = 0.003）。在空腹状态下，对照日血糖浓度略有下降，但应激测试日保持稳定（与对照日相比平均差值为 0.7 mmol/l，95%CI -0.7 至 2.0，P = 0.31）。
在餐后期间经历应激时，急性心理应激会显著增加 2 型糖尿病患者的血糖浓度。
