Grauslund AC, Lindkvist EB, Thorsen SU, Ballegaard S, Faber J, Svensson J, Berg AK. Pressure pain sensitivity: A new stress measure in children and adolescents with type 1 diabetes? World J Clin Pediatr 2024; 13(1): 89619 [PMID: 38596435 DOI: 10.5409/wjcp.v13.i1.89619]
Corresponding Author of This Article
Anna Korsgaard Berg, MD, PhD, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev 2730, Denmark. anna.korsgaard.berg@regionh.dk
Research Domain of This Article
Pediatrics
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Annemarie Cecilie Grauslund, Steffen Ullitz Thorsen, Jannet Svensson, Anna Korsgaard Berg, Department of Pediatrics, Herlev and Gentofte Hospital, Herlev 2730, Denmark
Emilie Bundgaard Lindkvist, Jannet Svensson, Anna Korsgaard Berg, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev 2730, Denmark
Steffen Ullitz Thorsen, Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
Søren Ballegaard, Jens Faber, Department of Endocrinology, Herlev and Gentofte Hospital, Herlev 2730, Denmark
Jannet Svensson, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
Author contributions: Grauslund AC, Ballegaard S, Faber J, Thorsen SU, Svensson J and Berg AK designed the research; Grauslund AC, Svensson J and Berg AK did the clinical visits and investigations; Grauslund AC and Berg AK analyzed the data; Grauslund AC prepared the first original draft; Ballegaard S validated the technique for measurement of PPS; Lindkvist EB helped with analytical tools; Svensson J, Thorsen SU and Berg AK supervised the first author; Lindkvist EB, Ballegaard S, Faber J, Thorsen SU, Svensson J and Berg AK reviewed and edited the manuscript. All authors have read and approved the final manuscript.
Supported byAase and Ejnar Danielsens Grant; Research grant from the Danish Diabetes Academy, No. NNF17SA0031406; and Research Program from Medtronic.
Conflict-of-interest statement: Grauslund AC: No conflicts of interest; Lindkvist EB: No conflicts of interest; Thorsen SU: No conflicts of interest; Ballegaard S: Invented the instrument used to measure PPS (Ullmeter, patent numbers: PA 2004-00349; PA 2004-00550) and is a shareholder of the firm that owns the PPS instrument (UllMeter A/S). In order to avoid bias, he was not involved in patient contact, collection of data or statistical analysis; Faber J: No conflicts of interest; Svensson J: No conflicts of interest; Berg AK: No conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anna Korsgaard Berg, MD, PhD, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev 2730, Denmark. anna.korsgaard.berg@regionh.dk
Received: November 7, 2023 Peer-review started: November 7, 2023 First decision: December 7, 2023 Revised: January 3, 2024 Accepted: January 29, 2024 Article in press: January 29, 2024 Published online: March 9, 2024 Processing time: 120 Days and 17.3 Hours
Abstract
Type 1 diabetes (T1D) is associated with general- and diabetes-specific stress which has multiple adverse effects. Hence measuring stress is of great importance. An algometer measuring pressure pain sensitivity (PPS) has been shown to correlate to certain stress measures in adults. However, it has never been investigated in children and adolescents. The aim of our study was to examine associations between PPS and glycated hemoglobin (HbA1c), salivary cortisol and two questionnaires as well as to identify whether the algometer can be used as a clinical tool among children and adolescents with T1D. Eighty-three participants aged 6-18 years and diagnosed with T1D were included in this study with data from two study visits. Salivary cortisol, PPS and questionnaires were collected, measured, and answered on site. HbA1c was collected from medical files. We found correlations between PPS and HbA1c (rho = 0.35, P = 0.046), cortisol (rho = -0.25, P = 0.02) and Perceived Stress Scale (rho = -0.44, P = 0.02) in different subgroups based on age. Males scored higher in PPS than females (P < 0.001). We found PPS to be correlated to HbA1c but otherwise inconsistent in results. High PPS values indicated either measurement difficulties or hypersensibility towards pain.
Core Tip: The aim of present study was to examine whether pressure pain sensitivity (PPS) in children and adolescents associates with other stress measures and determine if it can be used as a clinical tool in this population. Our study revealed some unexpected discrepancies examining PPS in a pediatric population with type 1 diabetes, highlighting the need for more research to validate if PPS is a clinically useful measure in children.
