The procedure allowed them to become more familiar with their BGL fluctuations. Participants were instructed to record their BGLs before and after every meal and to complete a daily blood glucose change chart for a week before the experiment. The protocol was approved by the Harvard University Institutional Review Board. At least a week before they came to the laboratory, we sent participants a package of forms and instructions, including a brief survey about medical history and conditions, a daily glucose diary, a glucose fluctuation chart, and fasting instructions. We used flyers and local advertisements to recruit 47 volunteers who have type 2 diabetes mellitus (≥12 mo duration 24 women mean age = 54.1 y, SD = 12.2 y) and who were being treated with diet and metformin, a biguanide antidiabetic medication. Positive findings would suggest that perceived time exerts a significant effect on the pace and rhythm of some natural physiological processes, including BGLs. If perceived time can also influence glucose levels, the research will provide further evidence of the inextricable relationship between mind and body. It has been reported that the manipulation of time perception can influence the intensity of perceived pain ( 15), as well as emotional responses ( 16). The purpose of the present study is to investigate the hypothesis that perceived time affects BGLs. We often feel hungry, for example, when we see it is lunchtime, despite having felt sated moments before ( 14). There is, however, reason to believe this may not necessarily be the case in general. Glucose levels in people with type 2 diabetes follow a particular time course, but how is the course determined? Current models suggest it is determined solely by physiological factors ( 13). No studies to our knowledge have investigated the potential for psychological mechanisms to directly influence BGLs. Apart from studies on depression and distress, limited efforts have been made to investigate the effect of psychological variables on blood sugar regulation. The majority of studies concerning psychological issues and diabetes have focused on depression, a serious comorbid condition ( 11), or on the negative effect of distress on disease management ( 12). Genetic factors appear to be a strong biological trigger ( 9), and obesity seems to be a powerful environmental trigger ( 10).Īlthough recognized as relevant psychosocial elements in diabetes management, few psychological factors have been studied for the effect they can exert on diabetic physiology. Its symptoms include periodic rises in blood glucose levels (BGLs) because the body produces insufficient insulin and/or resists the effects of insulin, leading to short-term severe shock and multiple long-term complications including strokes, neuropathies, kidney disease, and vision problems ( 8). Type 2 diabetes, the most common form of diabetes, is a chronic disease that affects millions ( 7). The connection between mind and body has received particularly limited attention in the study of metabolic disorders, such as diabetes. Despite a broad range of data describing the influence of mental states over the body, the role of psychological processes, especially when dealing with chronic health conditions, has been frequently underestimated. Similarly, study participants role-playing air force pilots, a group expected to have excellent vision, had better vision than control participants ( 6). For example, the expectation that an activity leads to a decrease in weight may result in an actual reduction of weight ( 4), and perceptions also change physiological responses to food consumption ( 5). The relationship between expectations and physiological responses has received much attention in the study of the placebo effect ( 1, 2), a phenomenon producing physiological changes in the body without specific biological stimulation ( 3).
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