Sarah Howard
Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
Related Stories
23 Comments
Do you think it would be beneficial to have an automated insulin delivery device that also measured your stress hormone levels, and used that in addition to your CGM readings to dose your insulin? Cancel reply
You must be logged in to post a comment.
Other. I am unsure what I think about an automated stress management feature as part of an insulin delivery device … Stress reactions and the release of stress hormones are highly individualized and unpredictable. Dealing with high and low levels of stress in everyday life is part of being human – do we need an insulin pump/cgm to monitor, measure and regulate the release of counter-regulatory stress hormones in us? Personally I think such a device feature could/would be unreliable and dangerous. People are better served learning & applying effective self-help stress management techniques to center, calm, and pace themselves in times of physical, emotional or psychological stress reactions.
❥❥❥ Stress hormones I am not as familiar with as growth hormones. The sheer quantity of growth hormones that fluctuate by the minute would be tremendously helpful. Mine seem to elevate at 0530 in the morning and around 1300 or 1400 in the afternoon. Go figure? ❥❥❥
I am a pastor. I use Medtronic’s hybrid system. On Sunday mornings as I begin worship services my adrenaline kicks in and drives my blood sugars up even if I haven’t eaten anything. I often bolus phantom carbs to keep BG in range because the hybrid system cannot keep up. Something that accounts for the adrenaline would be very useful.
I know stress affects my blood glucose, but it is very inconsistent. Sometimes raises, sometimes lowers, sometimes little effect on blood glucose. I sense this system is much more complex than a stress hormone level input and a blood glucose output. That said, we have to start someplace when figuring out complex systems. The initial model may be quite remedial, but it can be a knowledge building block.
Anthony said exactly what I was thinking. At first I was going to say no I would not want to have a system controlling that decision but we do need to take a look at that if we are going to get better closed loop control. Well said Anthony.
I have no idea because not only stress affects blood sugar #s. Lack of sleep, diet, exercise, all hormones, age, everything affects blood sugars for a T1D. It is hard to figure total coverage and automated insulin is still in the beginnings of clinical trials.
Lots of good comments. I said NA. To be honest at this point it is nothing but a hypothesis. I would have to see a lot of good data and animal and then human studies to be able to comment appropriately. For now I think it is challenging enough to manage my blood sugars on a day to day, hour to hour basis. But, if it can be proven that an algorithm and system can monitor stress hormone levels and it is proved it has an impact and I can improve dosing – of course I would go for it.
First of all, thanks for adding the thumbs up and replies. I think I agree with pretty much everyone. But here’s a question. If stress starts making your glucose go up (or down), wouldn’t the closed loop system already be making adustments based on that? Isn’t there a possibility of too much insulin by adding for rising glucose and rising stress?
I am not sure what benefit this would provide.
I use FreeAPS from Loop, and i notice every now and then that I rise so much of cortisol and adrenaline that is hard to keep in range or even a little out of range.
yes. It would be very helpful as I find that when I am stressful situations my blood glucose numbers go much higher and is hard to bring down. I can follow the graph on my Tandem pump and can correlate when the stress occurs.
Yes, I think it would be helpful. All efforts to personalize generic AID algorithms will increase the value of using a closed-loop system.
It might. Problem for me over the years, sometimes stress drives my blood sugars up & wow some wicked lows due to stress. This was before CGMS. Now with a CGM it might not be an issue. The reality to blood sugar management, the human body is very complex. Everything ties together, if one thing is out of sync, it will cause other things to be out of sync.
This would be a game-changer in the way the pump and CGM were when introduced. Many T1Ds have Schmidt’s Syndrome, a combo of T1D + Hashimoto’s + Addison’s (Primary Adrenal Insufficiency), requiring us to not only estimate and dose insulin 24/7, but also replacement steroids for our inability to make cortisol. Unlike T1D, there’s currently no testing option for making educating stress dosing, treatment is similar to how we dosed insulin prior to the invention of quick-acting modern types available today; standard dosing at standard times of day as a baseline treatment, and up-dosing for stress based on situation and interpretation of symptoms. If we had the ability to measure stress hormones on board, it would change the quality of life for many – especially those of us who rely on guesswork to dose steroids, which significantly impact bloodsugar levels in both directions.
Sometimes stress raises my blood sugar and sometimes it lowers my blood sugar. I would hope that tracking the changes in blood sugar would trigger the correct response by an AID no matter what caused the change (without needing to add another sensor to the equation).
Only if it measured estrogen-testosterone. Women have a much harder time than men due to the fact of fluctuating hormones every. Single. Month. A man definitely wrote this question.
Just on Monday i said to a nurse preparing me for surgery, “I don’t know how to bolus for stress.”… so, yes to the hundredth power, that would be helpful!!
I don’t currently have an AID, just my insulin pump and a CGM. Therefore I don’t know much about the theory of closed loop systems. However, it seems, as others have stated, that the system should be monitoring for highs and lows, and compensating, regardless of what are causing them. Is that too simple of a theory?
I really don’t know. My gut says no, but maybe it would be good for some people.
I don’t know. I don’t really understand how stress affects my blood sugar. I’ve noticed my blood sugar level going low in high stakes situations in the past, but the literature says stress leads to a rise in blood glucose.
YES of course! (I laughed at Amy Nance’s comment that the question had to be written by a man)! When I
had my periods, my bgs were on a constant rollercoaster.
Today, 66 years of T1D has taught me the effects of hormones and of STRESS. When I eliminate the amount of food, possible illness, or lack of exercise as the cause of elevated bg, the ONLY element I think I can’t is STRESS!!! I would love to see a device that could do that!!!
The effects of stress are far too variable and unpredictable to be able to effectively change insulin pump programing, in my view.
Need to see the what hormones are measured and how. Am aware that severe hypoglycemia increases adrenalin and subsequently might require higher insulin doses. Have not seen the research.