Interstitial glucose and subsequent affective and physical feeling states: A pilot study combining continuous glucose monitoring and ecological momentary assessment in adolescents

Jennifer Zink; Michele Nicolo; Kellie Imm; Shayan Ebrahimian; Qihan Yu; Kyuwan Lee; Kaylie Zapanta; Jimi Huh; Genevieve F Dunton; Michael I Goran; Kathleen A Page; Christina M Dieli-Conwright; Britni R Belcher

doi:10.1016/j.jpsychores.2020.110141

Interstitial glucose and subsequent affective and physical feeling states: A pilot study combining continuous glucose monitoring and ecological momentary assessment in adolescents

J Psychosom Res. 2020 Aug:135:110141. doi: 10.1016/j.jpsychores.2020.110141. Epub 2020 May 15.

Authors

Affiliations

¹ Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA.
² Division of Outcome Research, Department of Population Sciences, City of Hope National Medical Center, USA.
³ Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, USA.
⁴ Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA; Department of Psychology, University of Southern California, USA.
⁵ Department of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, USA.
⁶ Department of Medicine, Keck School of Medicine, University of Southern California, USA.
⁷ Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, USA.
⁸ Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA. Electronic address: bbelcher@usc.edu.

Abstract

Objective: Circulating glucose may relate to affective and physical feeling states reflective of emotional disorder symptoms. No prior studies have investigated within-day associations between glucose and subsequent affective and physical feeling states (positive affect, negative affect, and fatigue) as they occur naturally among healthy adolescents; this pilot study assessed these associations by combining data collected from ecological momentary assessment (EMA) and continuous glucose monitors (CGM).

Methods: Participants (N = 15, mean age = 13.1[±1.0] years, 66.7% female, 40.0% Hispanic, 66.7% healthy weight) wore a CGM for 7-14 days. Simultaneously, participants reported on their current positive affect, negative affect, and fatigue randomly during specified windows up to 7 times daily via EMA. CGM-measured mean interstitial glucose was calculated during the time windows (mean minutes = 122.5[±47.3]) leading up to each EMA prompt. Multilevel models assessed within-subject (WS) associations between mean interstitial glucose since the previous EMA prompt and EMA-reported affective and physical feeling states at the current prompt.

Results: Participants provided 532 interstitial glucose-matched EMA reports of affective and physical feeling states. During intervals when interstitial glucose was higher than one's usual, higher positive affect (WS β = 0.01, p < .0001, f² = 0.02) and lower fatigue (WS β = -0.01, p < .0001, f² = 0.09) were subsequently reported. Interstitial glucose was unrelated to negative affect (WS β = -0.002, p = .10, f² = 0.01). Associations were weakened, but remained significant following further adjustment for time of day.

Conclusions: Though effect sizes were small, within-person variations in interstitial glucose may relate to subsequent affective and physical feeling states among healthy youth. Investigations using similar methodologies in larger, more diverse samples are warranted.

Keywords: Blood glucose; Mood; Real-time; Within-subject; Youth.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Blood Glucose Self-Monitoring / psychology*
Ecological Momentary Assessment*
Exercise / physiology
Exercise / psychology
Fatigue / psychology
Female
Humans
Male
Pilot Projects

Abstract

Publication types

MeSH terms

Grants and funding