Maintenance of Glucose Control in Patients With Type 1 Diabetes During Acute Mental Stress by Riding High-Speed Rollercoasters

Abstract

A total of 20 patients with type 1 diabetes (all on intensified insulin treatment) were recruited from a recent study investigating the effect of acute moderate psychosocial stress on glucose concentrations (5). Patients were exposed to acute mental stress by riding on two different rollercoasters within 15 min. The first rollercoaster was a steel coaster starting from a height of 240 feet and reaching a speed of 79 mph with four positive Gs and the second an indoor coaster in absolute darkness. Blood pressure (by an ambulatory blood pressure monitoring device), heart rate (by 24-h electrocardiogram), and salivary cortisol were monitored during a preceding control day without stress application and on the stress testing day. Glucose concentrations were monitored in 5-min intervals by the Medtronic MiniMed continuous glucose monitoring system (CGMS). Capillary blood glucose concentrations were determined in 15- to 30-min intervals by reflectance meter (results not shown, consistent with CGMS data). A total of 10 patients performed the rides in the fasting state. Patients were allowed to drink water and injected their basal insulin as usual. An additional 10 patients were riding the rollercoasters 75 min after intake of a standard meal containing 50 g carbohydrates (with the same prandial insulin dose on both days). The rides were performed between 1:00 and 3:00 p.m. The protocol was approved by the ethics committee of the University Hospital of Zurich; all patients gave written informed consent.