Pressure pain sensitivity: A new stress measure in children and adolescents with type 1 diabetes?

Table 1 Pressure pain sensitivity and correlations to stress measures during the first study visit

	Age: 6-12 yr; (M = 24, F = 25)		Age: 13-18 yr; (M = 18, F = 16)		Total population; (M = 42, F = 41)
	Median (Q1; Q3), N (missing)	Rho (P value)	Median (Q1; Q3), N (missing)	Rho (P value)	Median (Q1; Q3), N (missing)	Rho (P value)
Pressure pain sensitivity1	85 (68; 99), 0		76 (66; 91), 0		81 (66; 96), 0
Perceived stress scale2	12 (8; 16), 23	-0.44 (0.02)3	16 (10; 18), 9	0.16 (0.45)	15 (9; 18), 32	-0.18 (0.20)
WHO-5	72 (64; 84), 7	0.29 (0.06)	62 (46; 76), 4	-0.21 (0.26)	68 (59; 80), 11	0.14 (0.23)
Salivary cortisol (nmol/L)	6.8 (5.8; 8.5), 0	-0.13 (0.38)	9.4 (5.6; 15.3), 0	-0.35 (0.045)3	7.4 (5.7; 10.4), 0	-0.25 (0.02)3
HbA1c (mmol/mol)	63 (53; 8), 0	-0.27 (0.06)	67 (59; 72), 1	0.35 (0.046)3	66 (53; 80), 1	-0.07 (0.51)

¹Pressure pain sensitivity score is an average of two to three measurements at the sternum. Third measurement was performed if a difference > 10 was present between the two first measurements. Distribution of cause of termination: First measurement: 18 with noxious withdrawal reflex, 65 said “stop”; second measurement: 15 with NWR, 66 said “stop”, 1 alarm; third measurement: 4 with NWR, 2 said “stop”.

²Answered by children above age 10 yr.

³Indicates a significant correlation (Spearman; P < 0.05).

M: Male; F: Female; Q1; Q3: First and third quartile; HbA1c: Glycated hemoglobin; WHO-5: World Health Organization-5 Well-Being Index.

Table 2 Within-variable differences between the two study visits and the correlations between changes in Pressure pain sensitivity and changes in Perceived stress scale, World Health Organization-5 Well-Being Index, salivary cortisol and glycated hemoglobin respectively

	Age: 6-12 yr; (M = 24, F = 25)		Age: 13-18 yr; (M = 18, F = 16)		Total population; (M = 42, F = 41)
	Median (Q1; Q3), N (missing)	Rho (P value)	Median (Q1; Q3), N (missing)	Rho (P value)	Median (Q1; Q3), N (missing)	Rho (P value)
Pressure pain sensitivity1	4.5 (0; 13), 0		3 (-2.9; 8.4), 0		3.5 (-0.8; 11.2), 0
Perceived stress scale2	-2 (-7; 0), 24	-0.08 (0.70)	1.5 (-2.3; 4.3), 10	0.06 (0.77)	-1 (-5; 3), 34	-0.04 (0.80)
WHO-5	4 (-8; 12), 8	-0.08 (0.63)	0 (-12; 8), 5	0.34 (0.068)	0 (-8; 11), 13	0.10 (0.43)
Salivary cortisol (nmol/L)	-0.07 (-0.38; 1.3)	-0.14 (0.33)	-0.2 (-3.1; 5.4), 0	0.25 (0.16)	-0.07 (-3.5; 0.75), 0	0.02 (0.87)
HbA1c (mmol/mol)3	0 (-5.5; 2.5), 4	0.05 (0.82)	0 (-5; 2.3), 2	0.45 (0.048)4	0 (-5; 2.5), 6	0.19 (0.22)

¹Pressure pain sensitivity score is an average of two to three measurements at the sternum. Third measurement was performed if a difference > 10 was present between the two first measurements. Distribution of cause of termination: First measurement: 18 with noxious withdrawal reflex, 65 said “stop”; second measurement: 15 with NWR, 66 said “stop”, 1 alarm; third measurement: 4 with NWR, 2 said “stop”.

²Answered by children above age 10 yr.

³Participants newly diagnosed with Type 1 Diabetes (duration < 3 months) were excluded from analyses (n = 49 participants remained, n = 27 aged 6-12 yr, n = 22 aged 13-18 yr).

⁴Indicates a significant correlation (Spearman; P < 0.05).

M: Male; F: Female; Q1; Q3: First and third quartile; HbA1c: Glycated hemoglobin; WHO-5: World Health Organization-5 Well-Being Index.