What fuels us?October 2014
Lesson 5: How does glucose dysregulation lead to disease?
The Cost of Stress
Can our psychological state affect our physical health?
Many depressed patients suffer from high levels of diabetes-specific emotional stress. Stress has long been suspected to have effects on the development of diabetes. More than 400 years ago, the famous English physician Thomas Willis (1621-1675) noted that diabetes often appeared among persons who had experienced significant life stresses, sadness, or long sorrow. Almost 300 years later, P.F. Slawsonfound that 80% of a group of diabetic patients gave a history of stress mainly in terms of losses, 1-48 months prior to the onset of diabetes (Slawson et al., 1963).
Recent and numerous studies have provided further support that stress contributes to type 2diabetes.
Signs of stress can be defined at a cognitive(e.g. changes in concentration), emotional (e.g. anxiety), physical (e.g. rapid heartbeat), or behavioral level (e.g. change in food or drug intake). A long-term activation of the stress system can have serious, negative consequences for the body (Bao et al., 2008).
One study has shown that depression increases the risk for type 2 diabetes by 37%. In another study, both anxiety and depression were associated with an increased risk for the development of type 2 diabetes at 10 years follow-up.
Interestingly, people who report high levels of stress compared to those with low levels of stress are less likely to quit smoking, less likely to exercise, and less likely to stop drinking during follow-up. All these other behaviors are also associated with increased risk for type 2 diabetes and could mediate the link between stress and diabetes. Anger appears to be associated with onset of type 2 diabetes as well. Another study analyzed data from 643 non-diabetic men with an average age of 63 years, and found the persons who reported a high level of stress and high hostility were more likely to have higher insulin resistance levels.
Poor sleep can be an important indicator of emotional stress as well. Emotional stress can easily affect different aspects of sleep, such as falling asleep, sleep duration, and sleep quality. However, sleeping problems may not only be a consequence of emotional stress, but can be experienced as a source of stress. It has been shown that short duration of sleep (less than 5 to 6 hours per night) significantly increases the risk for type 2 diabetes.
The effects of chronic stress are often made worse, by how people respond to stress: eating fatty foods, staying late at work, avoiding the treadmill, or drinking to excess.
Okay, so stress is heavily correlated with diabetes? But how and why? Stress is an evolutionary adaptation. The reaction causes epinephrine (adrenalin) and cortisol (another type of stress hormone) to enter the bloodstream to prepare body for a dangerous situation or famine. One of the many functions of these hormones is to help mobilize energy by releasing glucose into the blood.
Nowadays, humans don’t need to deal with saber tooth tigers. Instead stresses come in the form of bills, jobs, appointments, and the many other facets of modern day society. However, saber tooth tiger or twenty-first century society, the stress response remains the same. Adrenalin and cortisol levels still rise in response to stress causing glucose levels rise in the body. Most people do not engage in exercise, which would keep glucose levels stable. Instead, blood glucose levels remain elevated in the body. This is bad news for anyone who wants to minimize their risk for heart disease, cancer, diabetes and other illnesses. Because what is a huge risk factor for these diseases? Chronic high blood glucose. And as mentioned previously, not only does stress increase blood glucose, it also leads people partake in other unhealthy activities such as smoking, sleeping less, eating more, etc.
Why do some people seem more vulnerable to life's pressures than others? Personality, health habits, and coping mechanisms play a role. So what are the best ways to cope with stress? Reaching for a gallon of ice cream to soothe the tension of a family argument is not one of them, however, nor is forgoing exercise in favor of curling up on the sofa for an eight-hour marathon of “Family Guy''.
Modern day society inevitably brings many stresses to the table. The best ways to cope, turn out to be the time-honored ones: eat sensibly, get plenty of sleep, exercise regularly, stay away from soda and cigarettes,and finding peace amongst modern day pressures! It's a matter of making choices in your life.
References:
Article taken and adapted from:
Pouwer, F., Kupper, N., & Adriaanse, M. (2010, February). Does emotional stress cause type 2 diabetes mellitus? A review from the European depression in diabetes (EDID) research consortium. Discovery Medicine. Retrieved from
Goode, E. (2002, December). The heavy cost of chronic stress. The New York Times. Retrieved from
Image:
“Stress” image use given permission by Diane Cheney,
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