Stress and Diabetes

Stress and Diabetes

• Diabetes is a metabolic disorder characterized by chronic hyperglycemia due to defects in insulin secretion or action.
• There are two types of diabetes: Type I (DMI) and Type II (DM2).
• Type I Diabetes is an autoimmune reaction that destroys beta cells in the pancreas, hindering insulin production, and typically develops in childhood or adolescence.
• Type II Diabetes is a result of insulin resistance, where the pancreas fails to produce sufficient insulin, and is often managed through lifestyle changes and insulin support.

Biological Factors in Stress and Diabetes

• The Sympathetic Nervous System (SNS) response to stress decreases insulin production in the pancreas and releases glucose into the bloodstream.
• The Hypothalamic-Pituitary-Adrenal (HPA) axis response to stress increases blood glucose levels, causing hyperglycemia, and competes with glucose for uptake by cells.

Environmental Factors in Stress and Diabetes

• Family history plays a significant role in the incidence and severity of diabetes, with genetic risk and lifestyle factors contributing to the development of diabetes.
• Environmental stressors, including burnout, poverty, and social stigma, can impair glycemic control and increase the risk of developing Type II Diabetes.
• Dietary factors, such as eating patterns and the type of fat consumed, are also associated with the development of Type II Diabetes.

Psychological Factors in Stress and Diabetes

• Depression is a common co-morbid condition among adults with diabetes, and is associated with a 60-65% increased risk of diabetes mellitus.
• Depression can lead to abnormal HPA axis functioning, glucose dysregulation, and worse diabetes-related outcomes.
• Stress management training has been shown to reduce the risk of microvascular complications in patients with Type II Diabetes.

Studies on Stress and Diabetes

• A study on Pima Indians found that mental arithmetic tests induced an increase in blood glucose levels, but not in a control group of white subjects.

• A study on mice with Type II Diabetes found that stress enhanced the inability to deal with glucose, and that the interaction between diabetes and stress causes diabetic reactions.

• A study on healthy workers found an association between burnout and Type II Diabetes, with a 1.84-fold increased risk.### Diabetes Overview

• Diabetes mellitus (DM) is a metabolic disorder caused by a defect in insulin secretion or action, resulting in chronic hyperglycemia.

• Diabetes complications (if left untreated): nervous system disorders, blindness, kidney diseases, amputation, sexual dysfunction.

Classification of Diabetes

• Diabetes Mellitus Type 1 (DMI): an autoimmune reaction involving the destruction of beta cells in the pancreas, hindering insulin production.
• Diabetes Mellitus Type 2 (DM2): development of insulin resistance, where insulin is not properly utilized.

Biological Factors in Stress and Diabetes

• Sympathetic Nervous System (SNS) response: decreases insulin production in the pancreas and releases glucose into the bloodstream.
• Hypothalamic-Pituitary-Adrenal (HPA) axis: increases blood glucose levels, causing hyperglycemia, and affects diabetes management.

Stress and Diabetes

• Stress enhances the inability to deal with glucose, causing diabetic reactions.
• Environmental stress impairs glycemic control by interfering with dietary and treatment compliance in diabetics.

Burnout and Risk for Type II Diabetes

• Association of burnout with Type II diabetes in healthy workers (1.84-fold increase).

Depression and Type II Diabetes

• Clinically significant depression is associated with a 60-65% increased risk of diabetes mellitus.
• Depression is a common co-morbid condition among adults with diabetes, making diabetes management difficult.

Stress Management and Type II Diabetes

• Stress management training was associated with a small but significant (0.5%) reduction in Glycated hemoglobin test (HbA1c), measuring glucose levels in blood.

Social Stigma and Type II Diabetes

• Women in poverty, especially African American women, are at greater risk for developing Type II Diabetes due to limited access to healthy food and increased stress.
• Obesity is viewed as being under the person's control, leading to increased daily stress and feelings of blame, guilt, and helplessness, impacting diabetes management.