Psychological and Physiological Responses to Acute Laboratory Stressors in Insulin-Dependent Diabetes Mellitus Adolescents and Nondiabetic Controls

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Abstract
Thirty 11- to 18-year old adolescents with insulin-dependent diabetes mellitus (IDDM) of at least 1-year duration and 15 nondiabetic controls were subjected to three laboratory stressors: a venipuncture and two public-speaking tasks. Half of the IDDM participants were in good metabolic control prior to the inception of the experiment and half were in poor control. The IDDM adolescents in poor control and the nondiabetics were matched to the well-controlled IDDM group on the basis of age, sex, and race. The two IDDM groups were also matched on disease duration. Self-report, behavioral, and physiological measures of anxiety or arousal were monitored during the stress manipulations. Metabolic indices were monitored at the beginning and end of the experiment. The stressors induced increases in anxiety or arousal as measured by self-report, behavioral, and physiological measures in all three groups of participants. The two IDDM adolescent groups showed similar psychological and physiological reactions to the stressors that did not differ from those exhibited by the nondiabetic controls. There was no evidence that the acute stressors used in this investigation resulted in significant metabolic derangements in any of the groups studied. However, adolescents in poor diabetic control exhibited significantly higher heart rates throughout the study, compared to their well-controlled IDDM and nondiabetic peers. These data suggest that poor diabetic control may place even young patients with this disease at significant autonomic and cardiac risk.