J Geddes1, I J Deary, B M Frier. 1. Department of Diabetes, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, UK.
Abstract
AIMS/HYPOTHESIS: We examined the effects of acute insulin-induced hypoglycaemia on psychomotor function in non-diabetic volunteers and in adults with type 1 diabetes. METHODS: Non-diabetic adults (n = 20) and adults with type 1 diabetes mellitus (n = 16) each underwent a euglycaemic-hyperinsulinaemic glucose clamp on two separate occasions. Arterialised blood glucose was maintained for 1 h at either 4.5 mmol/l (euglycaemia) or 2.5 mmol/l (hypoglycaemia). During this time participants underwent neuropsychological tests to assess psychomotor function. RESULTS: During hypoglycaemia the non-diabetic participants showed a significant deterioration in the following: (1) four-choice reaction time (p = 0.008); (2) grooved pegboard (a test of manual dexterity; p = 0.004); (3) hand steadiness (p = 0.003); (4) pursuit rotor (a test of fine motor function, attention and coordination; p = 0.018); and (5) test of total body coordination (p = 0.004). No significant differences were observed between euglycaemia and hypoglycaemia in hand-grip (p = 0.897) and line tracing time (p = 0.480) tests. In type 1 diabetes mellitus patients, only four-choice reaction time (p = 0.023) and pursuit rotor (p = 0.045) were impaired significantly during hypoglycaemia. CONCLUSIONS/ INTERPRETATION: Although acute hypoglycaemia caused significant impairment of several psychomotor functions in non-diabetic adults, a lower magnitude of impairment was observed in those with type 1 diabetes. The mechanism underlying this discrepant effect of hypoglycaemia on psychomotor function remains unknown, but may be related to the difference in sympathoadrenal activation observed between the groups. People with type 1 diabetes may also have had a behavioural advantage of over non-diabetic participants derived from their previous exposure to hypoglycaemia or potentially the disparate results arose from hypoglycaemia-induced cerebral adaptation.
AIMS/HYPOTHESIS: We examined the effects of acute insulin-induced hypoglycaemia on psychomotor function in non-diabetic volunteers and in adults with type 1 diabetes. METHODS:Non-diabetic adults (n = 20) and adults with type 1 diabetes mellitus (n = 16) each underwent a euglycaemic-hyperinsulinaemic glucose clamp on two separate occasions. Arterialised blood glucose was maintained for 1 h at either 4.5 mmol/l (euglycaemia) or 2.5 mmol/l (hypoglycaemia). During this time participants underwent neuropsychological tests to assess psychomotor function. RESULTS: During hypoglycaemia the non-diabeticparticipants showed a significant deterioration in the following: (1) four-choice reaction time (p = 0.008); (2) grooved pegboard (a test of manual dexterity; p = 0.004); (3) hand steadiness (p = 0.003); (4) pursuit rotor (a test of fine motor function, attention and coordination; p = 0.018); and (5) test of total body coordination (p = 0.004). No significant differences were observed between euglycaemia and hypoglycaemia in hand-grip (p = 0.897) and line tracing time (p = 0.480) tests. In type 1 diabetes mellituspatients, only four-choice reaction time (p = 0.023) and pursuit rotor (p = 0.045) were impaired significantly during hypoglycaemia. CONCLUSIONS/ INTERPRETATION: Although acute hypoglycaemia caused significant impairment of several psychomotor functions in non-diabetic adults, a lower magnitude of impairment was observed in those with type 1 diabetes. The mechanism underlying this discrepant effect of hypoglycaemia on psychomotor function remains unknown, but may be related to the difference in sympathoadrenal activation observed between the groups. People with type 1 diabetes may also have had a behavioural advantage of over non-diabeticparticipants derived from their previous exposure to hypoglycaemia or potentially the disparate results arose from hypoglycaemia-induced cerebral adaptation.
Authors: Julia Pfützner; Juliane Hellhammer; Petra Musholt; Anke H Pfützner; Jan Böhnke; Hero Torsten; Ildiko Amann-Zalan; Manfred Ganz; Thomas Forst; Andreas Pfützner Journal: J Diabetes Sci Technol Date: 2011-01-01
Authors: Kate V Allen; Martin J Pickering; Nicola N Zammitt; Robert J Hartsuiker; Matthew J Traxler; Brian M Frier; Ian J Deary Journal: Diabetes Care Date: 2015-03-10 Impact factor: 19.112