Stress and Diabetes PDF

Thursday, March 14, 2024 Stress and Diabetes Diabetes Type I and II Diabetes mellitus (DM): a metabolic disorder caused by defect in insulin secretion or action resulting in chronic hyperglycaemia - glucose from foods is unable to get into the cells - Dysfunction of the pancreas disturbs glucose met...

Thursday, March 14, 2024 Stress and Diabetes Diabetes Type I and II Diabetes mellitus (DM): a metabolic disorder caused by defect in insulin secretion or action resulting in chronic hyperglycaemia - glucose from foods is unable to get into the cells - Dysfunction of the pancreas disturbs glucose metabolism - Diabetes complications (untreated): nervous system disorders, blindness, kidney diseases, amputation, sexual malfunction CLASSIFICATION OF DIABETES Diabetes Mellitus Type I (DMI): An autoimmune reaction involving the destruction of beta cells in the pancreas, therefore hindering the production insulin - Insulin-dependent diabetes or Juvenile diabetes - Rapidly develops in childhood or adolescence or progressively develops into latent autoimmune diabetes in adulthood - Insulin injection is needed for survival Diabetes Mellitus Type 2 (DM2): Development of insulin resistance in that insulin is not properly utilized - Non-insulin-dependent or adult-onset diabetes - Pancreas fails to produce suf cient levels of insulin for exceeding demand of insulin production due to high blood glucose level - Life style management is needed with insulin support - Progress in DM2 can lead to becoming insulin-dependent Biological factors in stress and diabetes SNS RESPONSE AND DIABETES SNS > Adrenal medulla > Epinephrine/Norepinephrine > Fight or flight response Fight or flight (short term) causes: - Decrease secretion in insulin production in pancreas - Liver releases glucose into blood stream HPA & DIABETES HPA > Pituitary > ACTH > Adrenal glands > Cortisol (glucocorticoids) Cortisol (long-term) causes: - Increase blood glucose levels causing hyperglycemia (high blood sugar) fi 1 Thursday, March 14, 2024 - Despite normal or even elevated insulin levels, blood glucose cannot be taken up by the cells - due to the blocking effect of cortisol increase (compete against glucose) Higher HPA axis activation is significantly associated with chronic diabetes complications such as neuropathy, retinopathy, and macroangiopathy Depressed immune system = autoimmune diseases (prone to develop DM1) Environmental factors in stress and diabetes STRESS EFFECT ON DIABETES Cortisol release = less insulin FAMILY HISTORY - Twins studies show that only 50% concordance for Type I Diabetes - Twin studies show almost 100% concordance for Type II Diabetes - Monozygotic twins living in a different environment for decades are concordant for Type II - Diabetes Monozygotic twins of even different weights are still concordant for Type II Diabetes genetic factors affect incidence and severity of diabetes Genetic risk + lifestyle = incidence of Diabetes Study — Stress Effects on Rats WiTh Type II Diabetes - Mice bread with Diabetes during pregnancy through a virus (vs mice healthy) - Can induce glucose intolerance = develop DM2 - Exposed mice to stress Results: The more stress = the higher blood glucose levels get Stress enhance the inability to deal with glucose Interaction of Diabetes X Stress = causes diabetic reaction ✓ Cannot absorb glucose under stress ✓ ONLY FOR MICE WITH GENETIC RISK Study — Environmental Stressors and Type II Diabetes ALL types of stress impairs glycemic control Environmental stress indirectly affects metabolic control by interfering with dietary and treatment compliance in diabetics Study — Dietary factors and Type II Diabetes Type 2 diabetes and obesity are twin epidemics Linear correlation between eating patterns and the development of Type II diabetes The type of fat: ✓ Saturated fat (opposed to monounsaturated and polyunsaturated fats) is more harmful with respect to fat-induced insulin insensitivity 2 Thursday, March 14, 2024 Study — Burnout and Risk for Type II Diabetes An association of burnout with Type II diabetes in healthy workers (1.84-fold increase). The incidence of type 2 diabetes were much higher in the high burnout workers than the low burnout workers Women in Poverty and Type II Diabetes African American women living in poverty at greater risk for developing Type II Diabetes than women with higher economic resources: ✓ healthier food is more expensive ✓ stress due to lack of resources Individuals with less resources may experience more stress in the face of loss because they have less resources to fall back on Study — Social Stigma and Type II Diabetes Obesity ! viewed as being under the persons control Leads to increase daily stress and feelings of blame, guilt, and helplessness ✓ Impacts diabetes management. ✓ Leads to a circular cycle of depression and bad life-style choices Psychological factors in stress and diabetes Study — Psychological Stress & Type II Diabetes Participants: Pima Indians (native) who have a strong genetic predisposition to Type II Diabetes Method:10-minute mental arithmetic test Results: arithmetic test induced an increase in blood glucose levels in Pima Indians but did not do so in a control group of white subjects Both groups showed similar cardiovascular and neuroendocrine responses to the stress 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 Difficult to manage diabetes Medication for depression tend to lead to weight gain leading to the development of Type II Diabetes - Depression also causes abnormal HPA axis functioning leading to glucose dysregulation - Depression has been associated with worse diabetes-related outcomes including poorer glycemic control and cardiovascular disease 3 Thursday, March 14, 2024 Study — Stress Management and Type II Diabetes Participants: Patients with type 2 diabetes Method: randomized to undergo a 5-session group diabetes education program with or without stress management training Results: Stress management training was associated with a small but signi cant (0.5%) reduction in Glycated hemoglobin test (HbA1c), measuring glucose levels in blood ✓ This is a significant reduction in risk of microvascular complications ✓ These results were significant at one year follow-up fi 4