Detection of symptoms by adolescents and young adults with type I diabetes during experimental induction of mild hypoglycemia

OBJECTIVE — To identify hormonal, psychological, and demographic predictors of symp-tom detection and accuracy of blood glucose estimation during mild hypoglycemia in adoles-cents and young adults with type 1 diabetes. RESEARCH DESIGN AND METHODS — During an insulin-glucose clamp study, 53 adolescents and 19 young adults estimated blood glucose levels and reported symptoms at euglycemia and after 30 min of mild hypoglycemia (3.3 mmol/l). Epinephrine and pancreatic polypeptide were measured, and both change in anxiety level during hypoglycemia and baseline level of anxiety were measured with the Spielberger Anxiety Inventory. Elevated levels of anxiety during euglycemia were used as an indicator of the psychological trait “negative affectivity.” Previous studies have suggested that individuals with higher negative affectivity are more inter-nally focused and, therefore, more likely to report somatic and visceral changes. RESULTS — During mild hypoglycemia, 42 % of the sample subjects reported an increase in autonomic symptoms; 29 % reported an increase in neuroglycopenic symptoms, and 28 % esti-mated blood glucose levels accurately (within 10 % of actual). Hormonal excursions did not predict any outcome, but higher anxiety levels during the euglycemic baseline were associate