Insulin absorption, glucose homeostasis, and lipolysis in IDDM during mental stress

Abstract

Objective: To study the effects of mental stress on the absorption kinetics of insulin and on glucose homeostasis and lipolysis in insulin-dependent diabetes mellitus (IDDM).

Research design and methods: Nine IDDM patients were exposed to the Stroop color word conflict test (CWT) during 40 min after injection of 125I-labeled soluble human insulin (10 U) into the abdomen. Adipose tissue blood flow (133Xe-clearance) was determined concomitantly to elucidate the importance of blood flow for insulin absorption during CWT. The effect of the CWT was followed by measurement of arterial levels of catecholamines and as blood pressure and heart-rate responses. Lipolysis was measured as arterial glycerol levels, and ketone body levels were monitored by determination by beta-hydroxybutyrate.

Results: Although insulin absorption (residual 125I-radioactivity and plasma free insulin levels) and the arterial levels of glucose and beta-hydroxybutyrate were not significantly changed by the CWT, arterial glycerol and norepinephrine levels and adipose tissue blood flow were approximately doubled, and epinephrine levels increased fourfold. Heart rate increased approximately 35 beats/min and mean blood pressure approximately 25 mmHg.

Conclusions: The results suggest that intense mental stress of 40 min duration does not alter the absorption of subcutaneously injected insulin, glucose homeostasis, or ketone body levels in patients with IDDM, despite a considerable increase in blood flow and lipolysis.