The implications of chronic psychological stress in the development of diabetes mellitus type 2

Abstract

Indroduction:Diabetes mellitus type 2 is a systemic disease with major negative effects on every organ and this is why the risk factors should be known and limited. In the past, in the majority perception, diabetes was associated especially with dietary factors, but psychological stress seems to be a factor incriminated in diabetes mellitus developement, too. Material and Method: During the writing of this review, there were used materials selected through search engines such as Pubmed, Web of Science, and Scopus, inserting formula: (diabetes*) AND (type 2 OR type two) AND (stress). The search included articles published in last 20 years with full text in english. Results and discussions: The complexity of the human body is distinguished through the fact that is biochemically prepared for defying every danger or risk factor by using two major physiological pathways: the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis (HPA) Even if proinflammatory cytokines are usually synthesized as a response of the human body to a certain disease, they can also be increased when a stressor occurs, a fact previously demonstrated. Another cytokine involved in diabetes pathogeny is IL-6 of which contribution to insulin secretion has been intensely researched. Cortisol has a major impact on the stress response, a fact previously demonstrated, but is also a considerable factor in glucose metabolism: it is a hyperglycemic hormone because has a stimulating action on gluconeogenesis and glycogenolysis. Another factor that contributes to diabetes mellitus type 2 pathogeny is the higher level of homocysteine found among people who have suffered chronic psychological stress Conclusions: The evolution of diabetes mellitus type 2 is severely affected by chronic psychological stress through modifications that occur in normal physiology, such as activation of the sympathetic nervous system, inhibition of the cholinergic pathway, synthesis of proinflammatory cytokines, or hyperproduction of homocysteine. These changes lead to hyperglycemia and insulin resistance, but they can be prevented by stress management procedures and treatment the stress-related diseases.