Evidence map›Paper›PMID 26969142›Full record

ArticleJournal of diabetes science and technology2016

Is Psychological Stress a Factor for Incorporation Into Future Closed-Loop Systems?

Linda A Gonder-Frederick, Jesse H Grabman, Boris Kovatchev, Sue A Brown, Stephen Patek, Ananda Basu, Jordan E Pinsker, Yogish C Kudva, Christian A Wakeman, Eyal Dassau and 3 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of diabetes science and technology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 32 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 2 countries.

Linda A Gonder-FrederickCenter for Diabetes Technology, University of Virginia, Charlottesville, VA, USA Behavioral Medicine Center, University of Virginia, Charlottesville, VA, USA lag3g@virginia.edu.
Jesse H GrabmanBehavioral Medicine Center, University of Virginia, Charlottesville, VA, USA.
Boris KovatchevCenter for Diabetes Technology, University of Virginia, Charlottesville, VA, USA Behavioral Medicine Center, University of Virginia, Charlottesville, VA, USA.
Sue A BrownCenter for Diabetes Technology, University of Virginia, Charlottesville, VA, USA.
Stephen PatekCenter for Diabetes Technology, University of Virginia, Charlottesville, VA, USA.
Ananda BasuEndocrine Research Unit, Mayo Clinic, Rochester, MN, USA.
Jordan E PinskerWilliam Sansum Diabetes Center, Santa Barbara, CA, USA.
Yogish C KudvaEndocrine Research Unit, Mayo Clinic, Rochester, MN, USA.
Christian A WakemanCenter for Diabetes Technology, University of Virginia, Charlottesville, VA, USA.
Eyal DassauWilliam Sansum Diabetes Center, Santa Barbara, CA, USA Department of Chemical Engineering, University of California, Santa Barbara, Santa Barbara, CA, USA John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge, MA, USA.
Claudio CobelliDepartment of Information Engineering, University of Padova, Padova, Italy.
Howard C ZisserDepartment of Chemical Engineering, University of California, Santa Barbara, Santa Barbara, CA, USA Insulet Corporation, Santa Barbara, CA, USA.
Francis J DoyleWilliam Sansum Diabetes Center, Santa Barbara, CA, USA Department of Chemical Engineering, University of California, Santa Barbara, Santa Barbara, CA, USA John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge, MA, USA.
University of Virginia · USMayo Clinic in Florida · USSansum Diabetes Research Institute · USHarvard University · USInsulet (United States) · USUniversity of Padua · IT

Funding

Mayo Clinic Center for Translational Science ActivitiesUL1TR000135 · NCATS · MAYO CLINIC ROCHESTER · PI KHOSLA, SUNDEEP · 2012 to 2015
$41.2M
Integrated Approaches to Close the Loop in Type 1 DiabetesR01DK085516 · NIDDK · UNIVERSITY OF VIRGINIA · PI BASU, ANANDA · 2009 to 2021
$6.5M
Ambulatory Artificial Pancreas: merging physiology, behavior, and control designDP3DK094331 · NIDDK · UNIVERSITY OF CALIFORNIA SANTA BARBARA · PI BASU, ANANDA, DOYLE, FRANCIS J · 2011 to 2014
$4.6M
Closed-loop Artificial Pancreas: Algorithm Engineering and Clinical EvaluationR01DK085628 · NIDDK · UNIVERSITY OF CALIFORNIA SANTA BARBARA · PI DOYLE, FRANCIS J, JOVANOVIC, LOIS · 2009 to 2013
$3.4M
NCATS NIH HHS UL1 TR000135NIDDK NIH HHS DP3 DK094331NIDDK NIH HHS R01 DK085516NIDDK NIH HHS R01 DK085628
6 · The paper itself

Abstract

backgroundThe relationship between daily psychological stress and BG fluctuations in type 1 diabetes (T1DM) is unclear. More research is needed to determine if stress-related BG changes should be considered in glucose control algorithms. This study in the usual free-living environment examined relationships among routine daily stressors and BG profile measures generated from CGM readings.

methodsA total of 33 participants with T1DM on insulin pumps wore a CGM device for 1 week and recorded daily ratings of psychological stress, carbohydrates, and insulin boluses.

resultsWithin-subjects ANCOVAs found a significant relationship between daily stress and indices of BG variability/instability (r = .172 to .185, P = .011 to .018, r(2) = 2.97% to 3.43%), increased % time in hypoglycemia (r = .153, P = .036, r(2) = 2.33%) and decreased carbohydrate consumption (r = -.157, P = .031, r(2) = 2.47%). Models accounted for more variance for individuals reporting the highest daily stress. There was no relationship between stress and mean daily glucose or low/high glucose risk indices.

conclusionsThese preliminary findings suggest that naturally occurring daily stressors can be associated with increased glucose instability and hypoglycemia, as well as decreased food consumption. In addition, findings support the hypothesis that some individuals are more metabolically reactive to stress. More rigorous studies using CGM technology are needed to understand whether the impact of daily stress on BG is clinically meaningful and if it is a behavioral factor that should be considered in glucose control systems for some individuals.

Indexed as

AlgorithmsInsulin Infusion SystemsAdultBlood GlucoseDiabetes Mellitus, Type 1FemaleHumansMaleMiddle AgedStress, PsychologicalBlood Glucoseblood glucose variabilitycontinuous glucose monitoringpsychological stresstype 1 diabetes

Identifiers

PMID26969142
PMCPMC5038545
OpenAlexW2293867659

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.