Psychomotor Performance and Counterregulatory Responses During Mild Hypoglycemia in Healthy Volunteers
Abstract
The effect of mild hypoglycemia on psychomotor performance and counterregulatory responses was studied among 12 healthy volunteers. Each volunteer received two modified hyperinsulinemic glucose clamps. One morning, plasma glucose was held constant at euglycemic levels (4.9 mM) for 95 min, and another morning, it was lowered over 35 min and then held constant at hypoglycemic levels (3.4 mM) for 60 min. A battery of psychomotor tests and a questionnaire assessing hypoglycemic symptoms were administered before and repeated during the last 30 min of each clamp. The questionnaire and three selected psychomotor tests were also administered repetitively during the 1st h of each clamp. During the hypoglycemic studies, a rise was seen in plasma epinephrine and pancreatic polypeptide at 45 min. An increase in symptom scores was first recorded at 50 min during the hypoglycemic studies [median 4 (range 0–13) vs. 2 (5-6), P < .05]. Performance was impaired on two psychomotor tests included in the battery. One was the trail making test on fine motor performance (–19.3 ± 4.2 targets/min, mean ± SE vs. 1.2 ± 4.8 targets/min, P < .05), and the other was the digitsymbol substitution (DSS) test on information processing and memory (18 ± 3 vs. 29 ± 4 symbols/min, P < .03). Of the tests administered during the 1st h, performance was impaired on the DSS. Thi impairment became significant at 45 min (14 ± 4 vs. 22 ± 4 symbols/min, P < .005). In conclusion, mild hypoglycemia selectively impairs psychomotor performance in healthy volunteers but not before the onset of glucose counterregulation and warning symptoms.
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Almost immediate reductions in cognitive performance occur when blood glucose concentrations fall below 3.4 mmol/L.
“almost immediate reductions in cognitive performance occur when blood glucose concentrations fall below 3.4 mmol·L -1 46-55”
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- Authors
- Stevens, A. B., McKane, W. R., Bell, P. M., Bell, P., King, D. J., & Hayes, J. R.
- Affiliations
- Queen's University Belfast (GB)
- ORCID
- Hayes, John R
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1989-01-01
- Volume
- 12
- Issue
- 1
- Pages
- 12-17
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2001356341
- Cited by
- 53
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2020: 1 · 2019: 2 · 2014: 1 · 2013: 2
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
- Keywords
- mild hypoglycemia, psychomotor performance, counterregulatory response, hypoglycemic symptoms, plasma epinephrine, pancreatic polypeptide, hyperinsulinemic-euglycemic clamp, Trail Making Test, Digit Symbol Substitution Test, information processing, memory, fine motor performance, healthy volunteers
- MeSH terms
- Adult, Blood Glucose, Female, Glucagon, Humans, Hypoglycemia, Insulin, Male, Pancreatic Polypeptide, Psychomotor Performance, Surveys and Questionnaires, Reference Values
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