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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Original Articles|
January 01 1989
Psychomotor Performance and Counterregulatory Responses During Mild Hypoglycemia in Healthy Volunteers
Anthony B Stevens, MB, MRCP;
Anthony B Stevens, MB, MRCP
Department of Medicine and the Department of Therapeutics and Pharmacology, The Queen's University of Belfast, Diabetic Clinic, Belfast City Hospital
Belfast, Northern Ireland, United Kingdom
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William R McKane, MB, MRCP;
William R McKane, MB, MRCP
Department of Medicine and the Department of Therapeutics and Pharmacology, The Queen's University of Belfast, Diabetic Clinic, Belfast City Hospital
Belfast, Northern Ireland, United Kingdom
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Patrick M Bell, MD, MRCP;
Patrick M Bell, MD, MRCP
Department of Medicine and the Department of Therapeutics and Pharmacology, The Queen's University of Belfast, Diabetic Clinic, Belfast City Hospital
Belfast, Northern Ireland, United Kingdom
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Paul Bell, MB, MRCPsych;
Paul Bell, MB, MRCPsych
Department of Medicine and the Department of Therapeutics and Pharmacology, The Queen's University of Belfast, Diabetic Clinic, Belfast City Hospital
Belfast, Northern Ireland, United Kingdom
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David J King, MD, FRCPsych;
David J King, MD, FRCPsych
Department of Medicine and the Department of Therapeutics and Pharmacology, The Queen's University of Belfast, Diabetic Clinic, Belfast City Hospital
Belfast, Northern Ireland, United Kingdom
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John R Hayes, MD, FRCP, FRCP
John R Hayes, MD, FRCP, FRCP
Department of Medicine and the Department of Therapeutics and Pharmacology, The Queen's University of Belfast, Diabetic Clinic, Belfast City Hospital
Belfast, Northern Ireland, United Kingdom
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Address correspondence and reprint requests to Dr. A. B. Stevens, Department of Medicine, University Floor, Belfast City Hospital, Lisburn Road, Belfast, Northern Ireland, UK.
Citation
Anthony B Stevens, William R McKane, Patrick M Bell, Paul Bell, David J King, John R Hayes; Psychomotor Performance and Counterregulatory Responses During Mild Hypoglycemia in Healthy Volunteers. Diabetes Care 1 January 1989; 12 (1): 12–17. https://doi.org/10.2337/diacare.12.1.12
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