Effects of acute insulin-induced hypoglycaemia on psychomotor function: people with type 1 diabetes are less affected than non-diabetic adults.
OBJECTIVE
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
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.
Geddes
J
J
Department of Diabetes, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, UK.
Deary
I J
IJ
Frier
B M
BM
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D004837:Epinephrine / Q000097:blood; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000503:physiopathology*; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D009638:Norepinephrine / Q000097:blood; D011597:Psychomotor Performance / Q000187:drug effects* / Q000502:physiology
D001786:Blood Glucose; D007328:Insulin; D009638:Norepinephrine; D004837:Epinephrine