Stress Increases The Risk Of Type 2 Diabetes Onset In Women: A 12-year Longitudinal Study Using Causal Modelling
Abstract Type 2 diabetes is associated with significant morbidity and mortality. Modifiable risk factors have been found to contribute up to 60% of type 2 diabetes risk. However, type 2 diabetes continues to rise despite implementation of interventions based on traditional risk factors. There is a clear need to identify additional risk factors for chronic disease prevention. The aim of this study was to examine the relationship between perceived stress and type 2 diabetes onset, and partition the estimates into direct and indirect effects. Methods and findings Women born in 1946–1951 (n = 12,844) completed surveys for the Australian Longitudinal Study on Women’s Health in 1998, 2001, 2004, 2007 and 2010. The total causal effect was estimated using logistic regression and marginal structural modelling. Controlled direct effects were estimated through conditioning in the regression model. A graded association was found between perceived stress and all mediators in the multivariate time lag analyses. A significant association was found between hypertension, as well as physical activity and body mass index, and diabetes, but not smoking or diet quality. Moderate/high stress levels were associated with a 2.3-fold increase in the odds of diabetes three years later, for the total estimated effect. Results were only slightly attenuated when the direct and indirect effects of perceived stress on diabetes were partitioned, with the mediators only explaining 10–20% of the excess variation in diabetes. Perceived stress is a strong risk factor for type 2 diabetes. The majority of the effect estimate of stress on diabetes risk is not mediated by the traditional risk factors of hypertension, physical activity, smoking, diet quality, and body mass index. This gives a new pathway Continue reading >>
The Role For Endoplasmic Reticulum Stress In Diabetes Mellitus
Accumulating evidence suggests that endoplasmic reticulum (ER) stress plays a role in the pathogenesis of diabetes, contributing to pancreatic β-cell loss and insulin resistance. Components of the unfolded protein response (UPR) play a dual role in β-cells, acting as beneficial regulators under physiological conditions or as triggers of β-cell dysfunction and apoptosis under situations of chronic stress. Novel findings suggest that “what makes a β-cell a β-cell”, i.e., its enormous capacity to synthesize and secrete insulin, is also its Achilles heel, rendering it vulnerable to chronic high glucose and fatty acid exposure, agents that contribute to β-cell failure in type 2 diabetes. In this review, we address the transition from physiology to pathology, namely how and why the physiological UPR evolves to a proapoptotic ER stress response and which defenses are triggered by β-cells against these challenges. ER stress may also link obesity and insulin resistance in type 2 diabetes. High fat feeding and obesity induce ER stress in liver, which suppresses insulin signaling via c-Jun N-terminal kinase activation. In vitro data suggest that ER stress may also contribute to cytokine-induced β-cell death. Thus, the cytokines IL-1β and interferon-γ, putative mediators of β-cell loss in type 1 diabetes, induce severe ER stress through, respectively, NO-mediated depletion of ER calcium and inhibition of ER chaperones, thus hampering β-cell defenses and amplifying the proapoptotic pathways. A better understanding of the pathways regulating ER stress in β-cells may be instrumental for the design of novel therapies to prevent β-cell loss in diabetes. Continue reading >>
- Exercise and Glucose Metabolism in Persons with Diabetes Mellitus: Perspectives on the Role for Continuous Glucose Monitoring
- Role of the Gastrointestinal Tract Microbiome in the Pathophysiology of Diabetes Mellitus
- Role of Medical Nutrition Therapy in the Management of Gestational Diabetes Mellitus
Diabetes: The Link To Oxidative Stress
Dr. Doni discusses how oxidative stress can lead to diabetes types 1 & 2, with 6 simple steps to prevent the onset of diabetes. In the first article in this series, I introduced how oxidative stress can affect your health. In it, I mentioned that elevated blood sugar levels are one of the key causes of oxidative stress and that is what I want to focus on today. There is more and more research linking diabetes to oxidative stress so, in this second article, I’m going to explain how oxidative stress can cause diabetes and offer some simple ways you can prevent this from happening. What Is Diabetes? We tend to think of diabetes as a single condition. In fact, it is a group of conditions—all of which affect the metabolism of carbohydrates and result in high blood sugar levels (known as hyperglycemia). In past articles, I have written about how blood sugar (also known as glucose) comes from sugar and all carbohydrates in your diet (even fruits and vegetables) – click here to read more. The only way for glucose to get from your blood into your cells—where it is used to give you energy—is for the hormone insulin to tell the cells to let the glucose into the cells. With diabetes, glucose cannot get into the cells, either because the cells are not responding as they should to insulin (what is known as insulin resistance, which leads to type 2 diabetes) or because insulin is not being produced by the pancreas, which is the case with type 1 diabetes. This lack of insulin production in type 1 diabetes is caused by an auto-immune process attacking the pancreas and damaging the cells that produce insulin. What’s the Difference between Diabetes Type 1 and 2? Type 1 diabetes is caused by an autoimmune response that is considered to be hereditary because it has been linked t Continue reading >>
Managing Stress When You Have Diabetes
Stress can hamper your diabetes care. For instance, if you have so much on your mind that you skip meals or forget to take your medicines, that will affect your blood sugar level. Life will always have challenges and setbacks, but you have the power to choose how you respond to it. Use these six tips as a start. 1. Keep a positive attitude. When things seem to be going wrong, it's easier to see the bad instead of the good. Find something to appreciate in each important area of your life, such as your family, friends, work, and health. That perspective can help you get through tough times. 2. Be kind to yourself. Do you expect too much from yourself? It's OK to say "no" to things that you don't really want or need to do. 3. Accept what you can't change. Ask yourself these three questions: "Will this be important 2 years from now?" "Do I have control over these circumstances?" "Can I change my situation?" If you can make things better, go for it. If not, is there a different way to handle it that would be better for you? 4. Talk to someone. You could confide in a trusted family member or close friend. There are also professionals who can listen and help you find solutions. Ask your doctor for recommendations if you'd like to see a psychologist or counselor. 5. Tap the power of exercise. You can blow off steam with hard exercise, recharge on a hike, or do a relaxing mind-body activity like yoga or tai chi. You'll feel better. 6. Take time to unwind. Practice muscle relaxation, deep breathing, meditation, or visualization. Your doctor may know of classes or programs that teach these skills. You can also check for apps that do that. Continue reading >>
Stress And Diabetes: A Review Of The Links
Evidence suggests that stressful experiences might affect diabetes, in terms of both its onset and its exacerbation. In this article, the authors review some of this evidence and consider ways in which stress might affect diabetes, both through physiological mechanisms and via behavior. They also discuss the implications of this for clinical practice and care. In recent years, the complexities of the relationship between stress and diabetes have become well known but have been less well researched. Some studies have suggested that stressful experiences might affect the onset and/or the metabolic control of diabetes, but findings have often been inconclusive. In this article, we review some of this research before going on to consider how stress might affect diabetes control and the physiological mechanisms through which this may occur. Finally, we discuss the implications for clinical practice and care. Before going any further, however, the meaning of the term stress must be clarified because it can be used in different ways. Stress may be thought of as a) a physiological response to an external stimulus, or b) a psychological response to external stimuli, or c) stressful events themselves, which can be negative or positive or both. In this article, we address all three aspects of stress: stressful events or experiences (sometimes referred to as stressors) and the physiological and psychological/behavioral responses to these. Role of Stress in the Onset of Diabetes Stressful experiences have been implicated in the onset of diabetes in individuals already predisposed to developing the disease. As early as the beginning of the 17th century, the onset of diabetes was linked to “prolonged sorrow” by an English physician.1 Since then, a number of research studies have i Continue reading >>
Does Emotional Stress Cause Type 2 Diabetes Mellitus? A Review From The European Depression In Diabetes (edid) Research Consortium
Specialty: Psychiatry, Epidemiology, Endocrinology Institution: Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University Address: Tilburg, Netherlands Author: Nina Kupper Specialty: Psychology, Biology Institution: Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University Address: Tilburg, Netherlands Author: Marcel C Adriaanse Specialty: Epidemiology, Psychology Institution: Section of Prevention and Public Health, Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam Address: Amsterdam, 1081 HV, Netherlands Abstract: According to the World Health Organization, approximately 220 million people worldwide have type 2 diabetes mellitus. Patients with type 2 diabetes not only have a chronic disease to cope with, they are also at increased risk for coronary heart disease, peripheral vascular disease, retinopathy, nephropathy, and neuropathy. The exact causes of type 2 diabetes are still not clear. Since the 17th century, it has been suggested that emotional stress plays a role in the etiology of type 2 diabetes mellitus. So far, review studies have mainly focused on depression as a risk factor for the development of type 2 diabetes mellitus. Yet, chronic emotional stress is an established risk factor for the development of depression. The present review provides an overview of mainly prospective epidemiological studies that have investigated the associations between different forms of emotional stress and the development of type 2 diabetes mellitus. Results of longitudinal studies suggest that not only depression but also general emotional stress and anxiety, sleeping problems, anger, and hostility are associated with an increased risk for the development of type 2 diabetes. Conf Continue reading >>
Diabetes And Stress
Stress, whether physical stress or mental stress, has been proven to instigate changes in blood sugar levels, which for people with diabetes can be problematic. While stress can affect diabetes control, both directly and indirectly, it can also be caused by various diabetic factors such as being diagnosed with diabetes, adjusting to a diabetes treatment regimen, or dealing with psychosocial pressures of the disease. What is stress? Simply out, stress is a state of emotional strain or tension that occurs when we feel that we can't cope with pressure. When we become stressed, the body quickly responds by releasing hormones that give cells access to stored energy - fat and glucose - to help the body get away from danger. This instinctive physiological response to perceived threats is known as the "fight-freeze, or flight" response. Over time, both physical and mental stress can wear us down mentally and lead to depression and other mental health issues. What can cause stress? We live in a very stressful society which is constantly putting us under pressure. This pressure can sometimes be too much to handle, leading us to feel "stressed out". This everyday feeling can be caused by simple things such as: Work pressure Marriage and relationships Parenting/children Health problems such as diabetes (see below) Financial insecurity Traffic Diabetes causing stress? Being told you have diabetes, or any serious chronic condition for that matter, can also cause a lot of stress and pressure. This can make it harder to control blood sugar levels which, in most cases, only adds to the frustration and stress. How does stress affect my diabetes? It is widely recognised that people with diabetes are who regularly stressed are more likely to have poor blood glucose control. One of the reas Continue reading >>
Work-related Stress And Type 2 Diabetes: Is There A Link?
It has been hypothesized that work-related psychosocial stress can increase the risk of developing type 2 diabetes. But some observational epidemiological studies that have examined this relationship have provided an unclear picture. In a study, researchers looked at whether work-related psychosocial stress is linked to the risk of type 2 diabetes. They defined work-related stress by a work-related stress model or by long work hours. Their findings appeared online in February 2012 in the article “Work-related stress and type 2 diabetes: systematic review and meta-analysis.” The article will appear in an edition of the journal Occupational Medicine. For the purposes of this study, a systematic review of the literature was performed through March 2010. Studies that were eligible to be included in this study were published observational epidemiological studies that involved adults in a community or occupational setting. Another inclusion criterion was the measurement of stress at the time of or prior to assessment of a subject’s type 2 diabetes status. Included studies measured stress based on a validated work-related stress model, or by number of hours worked. The researchers identified 9 studies: 4 prospective studies, 4 cross-sectional studies, and 1 case-control study. Where possible, the researchers performed meta-analysis to obtain summary odds ratios of the relationship between work-related stress and type 2 diabetes. Did Researchers Find a Link Between Work-related Stress and Type 2 Diabetes? The research team found that the meta-analyses did not show any statistically significant relationships between any aspects of work-related psychosocial stress or job strain and risk of developing type 2 diabetes. According to the meta-analysis that the researchers condu Continue reading >>
Stress And Type 2 Diabetes: A Review Of How Stress Contributes To The Development Of Type 2 Diabetes
Stress and Type 2 Diabetes: A Review of How Stress Contributes to the Development of Type 2 Diabetes Stress and Type 2 Diabetes: A Review of How Stress Contributes to the Development of Type 2 Diabetes Vol. 36:441-462 (Volume publication date March 2015) First published online as a Review in Advance on January 12, 2015 Center for Health and Social Care Research, Sheffield Hallam University, Sheffield S10 2BP, United Kingdom; email: [emailprotected] Current policy and research around type 2 diabetes (T2D) interventions largely invoke a behavioral model. We suggest that activation of the physiologic stress response (PSR) from chronic exposure to stressors, low socioeconomic status (SES), severe mental health problems, or aggressive behavior increases the risk of T2D. This article is a comprehensive review of the literature on the link between T2D and psychosocial factors focusing on prospective studies of the risk for developing diabetes. The review found an increased risk for T2D in people: exposed to stressful working conditions or traumatic events; with depression; with personality traits or mental health problems that put them in conflict with others; of low SES, either currently or in childhood; and in racial/ethnic minority populations, independent of current SES. This review suggests that T2D prevention research would be more effective if (a) the PSR to psychosocial factors (especially social disparities) was recognized and (b) intervention programs evaluated reduction in social disparities as part of a comprehensive approach. physiologic stress response , socioeconomic status , health inequalities , prospective studies Type 2 diabetes (T2D) is a group of conditions characterized by a background of insulin insensitivity and a failure of pancreatic insulin secretio Continue reading >>
Stress And Type 2 Diabetes: A Review Of How Stress Contributes To The Development Of Type 2 Diabetes.
Abstract Current policy and research around type 2 diabetes (T2D) interventions largely invoke a behavioral model. We suggest that activation of the physiologic stress response (PSR) from chronic exposure to stressors, low socioeconomic status (SES), severe mental health problems, or aggressive behavior increases the risk of T2D. This article is a comprehensive review of the literature on the link between T2D and psychosocial factors focusing on prospective studies of the risk for developing diabetes. The review found an increased risk for T2D in people: exposed to stressful working conditions or traumatic events; with depression; with personality traits or mental health problems that put them in conflict with others; of low SES, either currently or in childhood; and in racial/ethnic minority populations, independent of current SES. This review suggests that T2D prevention research would be more effective if (a) the PSR to psychosocial factors (especially social disparities) was recognized and (b) intervention programs evaluated reduction in social disparities as part of a comprehensive approach. KEYWORDS: health inequalities; physiologic stress response; prospective studies; socioeconomic status Continue reading >>
A Review Of The Evidence For A Neuroendocrine Link Between Stress, Depression And Diabetes Mellitus
Obesity and type 2 diabetes continue to be major public health burdens with type 2 diabetes rising in epidemic proportions. Since known risk factors do not explain all of the variance in the population, it is important to identify novel risk factors that can lead to development of new preventive measures. Chronic psychological stress and depression are associated with type 2 diabetes but the mechanism remains unclear. Neuroendocrine changes induced by these stressors, specifically activation of the hypothalamic-pituitaryadrenal (HPA) axis and sympathetic nervous system (SNS), might provide a unifying explanation. The objectives of this review are (1) to summarize the metabolic impact of HPA axis and SNS dysfunction induced by depression and stress, (2) to summarize the relation of neuroendocrine parameters to risk factors for diabetes, (3) to discuss the limitations of assessing neuroendocrine function in populationbased and intervention studies, and (4) to summarize the evidence of the impact of stress reduction, by cognitive behavior therapy (CBT), on neuroendocrine factors and on outcomes in diabetes and obesity. Continue reading >>
Stress And Diabetes: A Review Of The Links
... 37 Reports have confirmed the role of family and psycho- social stressors on poor adherence to diabetes care behaviors, with a presumed secondary effect on glycemic control in adolescents. 6, 39 Others suggest that psycho- social stress may directly contribute to poor glycemic control in adolescents-that is, not solely through its effect on adherence to diabetes self-care. 7 Among LEAP study participants, we have documented an association between the number of stressful life events and glycemic control. ... ... 5 All these data suggest that stress reduction is a valid target for intervention in T1D to improve glycemic control, either through direct effects on stress physiology or indirectly by improving adher- ence to diabetes self-care behaviors such as increased home glucose monitoring or adherence to insulin therapy. The importance of addressing stress and directly pro- moting stress reduction is further highlighted by our finding that independent of intervention group, a reduc- tion in perceived stress was associated with a reduction in A1C. While this finding is not novel, it is to our know- ledge the first time that longitudinal changes in stress and glycemic control have been shown to be related to a young adult diabetic population in transition. ... ... The etiology of diabetes involves several factors; and it is considered as an autoimmune disorder (Castano, II-Percentage blood glucose reduction after oral administration of metformin 18 mg/200 g body weight, disopyramide 3.6 mg/200g body weight, disopyramide single dose study and multiple dose study in diabetic rats (n=6) Eisenbarth, 1990). The major factor considered to be involved is stress, which is particularly so in the case of type-2 diabetes ( ). Moreover, whether it is type 1 or type 2 diabetes, wh Continue reading >>
Does Hsp60 Provide A Link Between Mitochondrial Stress And Inflammation In Diabetes Mellitus?
Does Hsp60 Provide a Link between Mitochondrial Stress and Inflammation in Diabetes Mellitus? School of Science, University of Waikato, Private Bag 3105, Hamilton 3240, New Zealand Received 11 April 2016; Revised 10 June 2016; Accepted 13 June 2016 Copyright 2016 Joshua Juwono and Ryan D. Martinus. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The focus of this review is to summarise the known relationships between the expression of heat shock protein 60 (Hsp60) and its association with the pathogenesis of Type 1 and Type 2 diabetes mellitus. Hsp60 is a mitochondrial stress protein that is induced by mitochondrial impairment. It is known to be secreted from a number of cell types and circulating levels have been documented in both Types 1 and 2 diabetes mellitus patients. The biological significance of extracellular Hsp60, however, remains to be established. We will examine the links between Hsp60 and cellular anti- and proinflammatory processes and specifically address how Hsp60 appears to affect immune inflammation by at least two different mechanisms: as a ligand for innate immune receptors and as an antigen recognised by adaptive immune receptors. We will also look at the role of Hsp60 during immune cell activation in atherosclerosis, a significant risk factor during the pathogenesis of diabetes mellitus. Diabetes mellitus is a spectrum of metabolic disorders characterised by chronic hyperglycaemia and abnormalities within the metabolism of proteins, fats, and carbohydrates [ 1 ]. The two most common forms of diabetes are classified as Type 1 and 2. Type 1 also known as insulin-dependent diabetes ( Continue reading >>
Oxidative And Endoplasmic Reticulum Stress In -cell Dysfunction In Diabetes
Oxidative and endoplasmic reticulum stress in -cell dysfunction in diabetes 1Immunity, Infection and Inflammation Program, Mater Research Institute, Translational Research Institute, University of Queensland, 37 Kent Street, Woolloongabba, Brisbane, Queensland 4102, Australia 2Metabolic Diseases Program, Mater Research Institute, The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane, Queensland 4102, Australia Correspondence should be addressed to M A McGuckin; Email: michael.mcguckin{at}mater.uq.edu.au The inability of pancreatic -cells to make sufficient insulin to control blood sugar is a central feature of the aetiology of most forms of diabetes. In this review we focus on the deleterious effects of oxidative stress and endoplasmic reticulum (ER) stress on -cell insulin biosynthesis and secretion and on inflammatory signalling and apoptosis with a particular emphasis on type 2 diabetes (T2D). We argue that oxidative stress and ER stress are closely entwined phenomena fundamentally involved in -cell dysfunction by direct effects on insulin biosynthesis and due to consequences of the ER stress-induced unfolded protein response. We summarise evidence that, although these phenomenon can be driven by intrinsic -cell defects in rare forms of diabetes, in T2D -cell stress is driven by a range of local environmental factors including increased drivers of insulin biosynthesis, glucolipotoxicity and inflammatory cytokines. We describe our recent findings that a range of inflammatory cytokines contribute to -cell stress in diabetes and our discovery that interleukin 22 protects -cells from oxidative stress regardless of the environmental triggers and can correct much of diabetes pathophysiology in animal models. Finally we sum Continue reading >>
Stress: How It Affects Diabetes And How To Decrease It
Diabetes management is a lifelong process. This can add stress to your daily life. Stress can be a major barrier to effective glucose control. Stress hormones in your body may directly affect glucose levels. If you’re experiencing stress or feeling threatened, your body reacts. This is called the fight-or-flight response. This response elevates your hormone levels and causes your nerve cells to fire. During this response, your body releases adrenaline and cortisol into your bloodstream and your respiratory rates increase. Your body directs blood to the muscles and limbs, allowing you to fight the situation. Your body may not be able to process the glucose released by your firing nerve cells if you have diabetes. If you can’t convert the glucose into energy, it builds up in the bloodstream. This causes your blood glucose levels to rise. Constant stress from long-term problems with blood glucose can also wear you down mentally and physically. This may make managing your diabetes difficult. Stress can affect people differently. The type of stress that you experience can also have an impact on your body’s physical response. When people with type 2 diabetes are under mental stress, they generally experience an increase in their blood glucose levels. People with type 1 diabetes may have a more varied response. This means that they can experience either an increase or a decrease in their blood glucose levels. When you’re under physical stress, your blood sugar can also increase. This can happen when you’re sick or injured. This can affect people with type 1 or type 2 diabetes. Keeping track of additional information, such as the date and what you were doing at the time you were stressed, may help you determine specific triggers. For example, are you more stressed on Continue reading >>
