How exposure to chronic stress contributes to the development of type 2 diabetes: a complexity science approach

The hypothalamic–pituitary–adrenal axis is a tightly regulated system that represents one of the body’s mechanisms for responding to acute and chronic stress. Prolonged stress and/or inadequate regulation of the stress system can lead to a condition of chronic hypercortisolism or, in some cases, a blunted cortisol response to stress, contributing to insulin resistance, increased adiposity and type 2 diabetes mellitus. Moreover, acute and chronic stress can exacerbate or worsen metabolic conditions by supporting an inflammatory state and a tight relationship between stress, inflammation and adipose tissue has been reported and has been a growing subject of interest in recent years. We reviewed and summarized the evidence supporting hypothalamic–pituitary–adrenal axis dysregulation as an important biological link between stress, obesity, inflammation and type 2 diabetes mellitus. Furthermore, we emphasized the possible role of infectious-related stress such as SarsCov2 infection in adrenal axis dysregulation, insulin resistance and diabetes in a bidirectional link. Understanding and better defining the links between stress and obesity or diabetes could contribute to further definition of the pathogenesis and the management of stress-related complications, in which the HPA axis dysregulation has a primary role.

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The Georgia Cardiovascular Twin Study: Influence of Genetic Predisposition and Chronic Stress on Risk for Cardiovascular Disease and Type 2 Diabetes

Twin Research and Human Genetics ◽

10.1375/twin.9.6.965 ◽

2006 ◽

Vol 9 (6) ◽

pp. 965-970 ◽

Cited By ~ 19

Author(s):

Dongliang Ge ◽

Yanbin Dong ◽

Xiaoling Wang ◽

Frank A. Treiber ◽

Harold Snieder

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Environmental Factors ◽

Chronic Stress ◽

Twin Study ◽

Potential Interaction ◽

Longitudinal Change ◽

The Impact

AbstractThe Georgia Cardiovascular Twin Study is a longitudinal study of biobehavioral antecedents of cardiovascular disease in youth and young adults, including around 500 twin pairs with roughly equal numbers of African Americans and European Americans. Focus of study includes the longitudinal change in relative influence of genetic and environmental factors (especially chronic stress) on development of risk factors for cardiovascular disease. Approaches include quantitative genetic modeling of phenotypic twin data as well as the examination of the influence of polymorphic variation in candidate genes and their potential interaction with environmental factors on these risk factors. Future work will expand the scope of the study to investigating the impact of chronic stress as measured by indices of the hypothalamus-pituitary-adrenal axis and the sympathetic nervous system on preclinical markers of cardiovascular disease, essential hypertension and type 2 diabetes.

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Association of oxidative stress and inflammatory markers with chronic stress in patients with newly diagnosed type 2 diabetes

Diabetes/Metabolism Research and Reviews ◽

10.1002/dmrr.3147 ◽

2019 ◽

Vol 35 (5) ◽

Cited By ~ 8

Author(s):

Azaz Siddiqui ◽

Nimesh G. Desai ◽

Suman B. Sharma ◽

Mohammad Aslam ◽

Uday K. Sinha ◽

...

Keyword(s):

Oxidative Stress ◽

Type 2 Diabetes ◽

Chronic Stress ◽

Inflammatory Markers ◽

Newly Diagnosed

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Questions in diabetology to be elucidated

Orvosi Hetilap ◽

10.1556/oh.2011.29169 ◽

2011 ◽

Vol 152 (34) ◽

pp. 1353-1361 ◽

Cited By ~ 3

Author(s):

Kornél Simon ◽

Edit Dobó ◽

Anikó Szépvölgyi ◽

Estilla Szalczer ◽

Szilvia Kazup ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

Cardiovascular Risk Factors ◽

Chronic Stress ◽

Life Style ◽

Causal Role

Despite advances in the management of cardiovascular diseases, the incidence of cardiovascular diseases is increasing both in developed and developing world. This phenomenon is associated with the worldwide pandemic of obesity and type 2 diabetes; both are related to the life style of urbanization. The association between life conduct of civilization and chronic stress resulting in augmentation of cardiovascular risk is detailed. Therapeutic policy practiced nowadays (polypill administration, achieving target values) in order to reduce cardiovascular risk is criticized. Primary causal role of chronic stress and life style, and secondary resultant nature of cardiovascular risk factors are stressed out in the pathogenesis of increased cardiovascular risk; therefore, limited value of an approach focusing on the management of cardiovascular risk factors, instead of targeting the primary cause, i.e. chronic stress and life conduct is emphasized. A short account is given about the similarities and dissimilarities in the pathogenesis of macro- and microangiopathy. The primary causal role of chronic stress in fetal and adult diabetes, furthermore possible triggers evoking chronic stress is discussed. Supportive experimental and clinical data are reported about the nature of basic metabolic dysregulation (dysmetabolism) in the pathogenesis of metabolic syndrome and type 2 diabetes. Besides the well documented significance of ischemic clinical manifestations of diabetes, the role of non-ischemic diabetic cardiomyopathy as an independent risk factor in evoking the total burden of cardiovascular risk in diabetes is emphasized. In reducing the cardiovascular risk in diabetics the management of high blood pressure and dyslipidemia is more effective compared to that of hyperglycemia. Besides managing cardiovascular risk factors, the successful treatment of dysmetabolism is importantly needed to eliminate the total excessive cardiovascular risk in diabetes. In order to achieve this goal the potential role of metabolic promoters is stressed out. Orv. Hetil., 2011, 152, 1353–1361.

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