Effect of acute psychotic stress in nondiabetic subjects on (beta)-cell function and insulin sensitivity

OBJECTIVE-To determine the effect of acute psychotic stress on glucose homeostasis in nondiabetic subjects. RESEARCH DESIGN AND METHODS-ß-Cell function and insulin sensitivity were determined by the homeostasis model assessment in 39 nondiabetic patients with acute psychotic stress reaction admitted to a psychiatric ward. The clinical global impression (CGI) score was used to evaluate the level of psychological stress. Patients were assessed on admission, after 2 weeks, before discharge, and 6 months after discharge. RESULTS-The mean CGI score decreased significantly with time: 5.3 ± 0.8 and 1.6 ± 0.7 on admission and predischarge, respectively (P < 0.001). This was associated with a significant reciprocal increase of mean ß-cell function from 96.8 ± 33.2 to 134.4 ± 60% at admission and postdischarge, respectively (P < 0.003), and a decrease of mean insulin sensitivity from 101.7 ± 36 to 77.1 ± 34.8% (P < 0.001). In contrast, mean glucose and HbA1c levels did not change significantly. Subgroup analysis demonstrated that patients with the highest stress score on admission (6) had significantly higher glucose (P = 0.01) and insulin levels (P = 0.04) than patients with lower score (