Psychosocial sequelae of visual loss in diabetes.

This study evaluated whether degree of related visual impairment is associated with degree of psychological symptoms in general, and specifically more somatization, depression, anxiety, phobic anxiety, fear of hypoglycemia, and stress. A total of 49 volunteer subjects with diabetes-induced visual impairment were subdivided into totally blind and partially sighted groups, and were compared with 62 nonvisually impaired adults with diabetes. All were given the Brief Symptom Index, the Hypoglycemic Fear Survey, and the Perceived Stress Scale, along with a general questionnaire assessing demographic characteristics. Mean scores of the partially sighted group did not differ from the nonvisually impaired group, but the blind subjects reported more general psychological symptoms, somatization, anxiety, and phobic anxiety. Significantly more blind than sighted subjects exhibited clinical elevations on anxiety, phobic anxiety, and fear of hypoglycemia. Regression analysis confirmed the significant visual loss on psychological functioning and revealed large individual differences in how patients respond to visual loss. (ABSTRACT TRUNCATED)

Disruptive effects of acute hypoglycemia on speed of cognitive and motor performance.

OBJECTIVE: To directly examine whether hypoglycemia differentially slows cognitive versus motor function, to evaluate the reliability of hypoglycemic-related slowing, and to examine factors contributing to individual differences. RESEARCH DESIGN AND METHODS: IDDM subjects (n = 10) were administered a pure cognitive and a pure motor neuropsychological test at euglycemia (5.4 mmol), blood glucose nadir (2.6 mmol), postnadir (3.6 mmol), and again at euglycemia (6.7 mmol). To assess the practice effect, matched control subjects were tested at similar time intervals. RESULTS: Concurrent and test-retest reliability for all tests was robust (r = 0.68-0.94). Only cognitive tasks demonstrated impairment at nadir (P < 0.04). Individual differences, in terms of cognitive impairment, were significantly correlated with levels of blood glucose at nadir and baseline performance. CONCLUSIONS: Cognitive tasks appear to be more sensitive to neuroglycopenia than motor tasks. Cognitive impairment caused by hypoglycemia is reliable and differs across subjects. Individuals who show reliable sensitivity to cognitive impairments of hypoglycemia should avoid moderately low blood glucose levels.