EFFECTS ON BLOOD-GLUCOSE PERCEPTION OF EXERCISE AND ALCOHOL IN IDDM PATIENTS

Recent research has demonstrated that patients with insulin-dependent diabetes mellitus (IDDM) are able to perceive their blood glucose (BG) levels by using 'internal' physical symptoms and various external inf ormation mainly based on knowledge about diabetes and experience with self monitoring of BG, We studied the effects on Brf perception of two 'external' factors, exercise and consumption of alcohol, which possib ly influence perception especially of low BG levels. BG levels of 9 ID DM patients were monitored from 18.00 to 06.00 h under 4 conditions: E (exercise, 19.00 - 22.00 h, 30% maximum work load), A (alcohol, 22.00 h, resulting in a serum level of 14 mmol/l). EA (exercise and alcohol ) and R (resting). The patients estimated their BG levels hourly befor e measurement, Accuracy was assessed by error grid analysis and report ed as accuracy index, reaching from - 100% to +100%. Accuracy of BG pe rception was significantly) higher during nights with exercise (E: 50 +/- 7% EA: 41 +/- 7%) compared to nights without exercise (A: 37 +/- 1 2%, R: 22 +/- 6%, mean +/- SEM, p < 0.05, MANOVA). BG perception tende d to be worse after consumption of alcohol, The sensitivity for BG lev els less than 3.9 mmol/l was reduced during resting nights (R: 14%, A: 50%, EA: 63%, E: 69%), This study suggests an important influence of external conditions on perception of BG, Exercise acts as an external factor and increases the patients' abilities to predict their BG conce ntrations accurately whereas alcohol seems to affect perception of BG adversely.