The Relationship Between Stress and Diabetes

The reason that diabetes is such a major public health problem stems less from the consequences of insufficient insulin production per se than from the complications that may develop. Diabetes is associated with a thickening of the arteries due to the buildup of wastes in the blood. As a consequence, diabetic patients show high rates of coronary heart disease.

Both type I (insulin dependent) and Type II (non insulin-dependent) diabetics are sensitive to the effects of stress.

Stress may precipitate Type I diabetes in individuals with the affected gene. People at high risk for diabetes show abnormal glycemic responsiveness to stress, which, when coupled with the experience of intermittent or long-term stress, may be implicated in the development of the disease. Stress also aggravates both type I and Type II diabetes after the disease is diagnosed.

At least 14 studies have reported direct links between stress and poor diabetic control. This relationship is not caused by differences in adherence to medications, coping efforts, insulin regimen, diet, or exercise, although stress can also adversely affect adherence and diet.

Just as they appear to be complicated in the development of coronary heart disease and hypertension, anger and hospitality may be implicated in higher glucose levels, and an examination of their role in the potential aggravation of diabetes is warranted. Diabetic patients with depression appear to be at enhanced risk for coronary heart disease.
Although the actual mechanism involved in the aggravating of diabetes by stress is still being explored, it is clear that glucose supplies cells with energy, and insulin is responsible for glucose storage. In the presence of stress hormones, such as cortisol, however, insulin is less effective in facilitating glucose storage. In the presence of stress hormones, such as cortisol, however, insulin is less effective in facilitating glucose storage. This process may result in increased insulin secretion. When insulin is high, systolic blood pressure and heart rate also tend to be elevated. When these processes are combined with overeating and inactivity, the results can lead to obesity, causing further insulin resistance and higher insulin secretion.

Just as sympathetic nervous system reactivity is implicated in the development of coronary heart disease and hypertension, it likewise appears to be involved in the pathophysiology of Type II diabetes. In particular, a hyperresponsivity to epinephrine,, higher levels of circulating catecholamine's, and elevated levels of endogenous opiod-peptides are found in many diabetes patients. Thus, theoretically, as is he case with heart disease and hypertension patients, interventions to reduce sympathetic nervous system activity can be useful for modulating hyperglycemia.

Reference:

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