Does Stress Lead to Increased Diabetes Risk?
It is believed that improperly unmanaged stress is a major determinant in almost all illness conditions. Does stress also leads to diabetes? Let us investigate.
There are two major types of diabetes: type 1 diabetes mellitus and type 2 diabetes mellitus.
Type 1 diabetes mellitus is also known as juvenile diabetes because it starts in children and young adults. It is due to insufficient amount of insulin being produced (known as insulin deficiency). Since it does not start later in life, we can safely conclude that type 1 diabetes mellitus is unlikely to be caused by stress.
Type 2 diabetes mellitus usually occurs later in life, after the age of forty. Type 2 diabetes mellitus is the most common form of diabetes. In type 2 diabetes mellitus, the problems arise because
1. Either the body does not produce enough insulin, or
2. The insulin produced is ignored by the cells in the body (known as insulin resistance), or both.
Discussion on what insulin is and what the roles it plays is in order.
Insulin is a hormone that regulates carbohydrate metabolism (and to some extent fat metabolism as well). Insulin helps the body to use sugar. Sugar is the basic source of energy for the cells in the body, and insulin takes the sugar from the blood into the cells.
When we say blood sugar, we refer to glucose in the blood. Glucose is the main type of simple sugar in our blood. Our body needs to have glucose level controlled to within a narrow range (0.7-1.1 mg per ml). Below 0.7 mg per ml is termed "hypoglycemia", and above 1.8 mg per ml is termed "hyperglycemia". Both can result in problems as we shall see later.
When there is more glucose in the blood, more insulin is secreted into the blood, resulting in cells (muscle cells, red blood cells and fat cells) absorbing the glucose out of the blood, thus reducing the blood glucose level.
When there is less glucose in the blood, more glucagon (counter part of insulin) is secreted into the blood, stimulating liver to release the glucose it has stored in its cells into the blood stream, thus increasing blood glucose. Glucagon also induces the liver and some of the muscle cells to produce glucose out of protein.
If the glucose does not go into cells, instead it builds up in the blood, two problems arise. Firstly, if the cells do not get the glucose they need, they die. Secondly, prolong period of high blood glucose levels may hurt your eyes, kidneys, nerves or heart. Insulin is used to treat this "hyperglycemia" aspect of diabetes.
"Hypoglycemia" or low blood glucose level condition can happen when more insulin is introduced than there is food in the stomach to be acted on. This often happens when a patient injects insulin in anticipation of food consumption, but the food consumption is delayed or insufficient food is consumed. Symptoms of "hypoglycemia" include strange behavior, clumsy or jerky movements, seizure, confusion, tingling sensations around the mouth, dizziness, sweating, headache etc.
Now that we understand the mechanics of diabetes, is there anything to suggest that stress can cause diabetes (type 2)?
The usual reason explaining where stress lead to sickness is the weakening of our immunity system caused by stress. However, diabetes is not caused by weak immunity system.
Psychological stress caused by the death of a spouse, a financial crisis or other life-altering event has been associated with higher risk of developing diabetes in middle age. Many studies have shown that the abovementioned types of major life events were associated with type 2 diabetes regardless of family history of the disease, exercise or alcohol use. However, although such circumstantial evidence seems to suggest a link between a higher proportion of people under greater stress and diabetes, we cannot conclude that stress cause diabetes.
There is a theory that says that stressful life events increase the diabetes risk by increasing levels of the hormone cortisol and decreasing levels of sex steroids such as testosterone, which have been shown to influence the action of insulin.
Some researchers have tried to determine whether stress, which can be measured using the ratio cortisol:testosterone, affects insulin resistance. In the prospective study by George Davey Smith and colleagues from the University of Bristol in the United Kingdom, cortisol:testoterone ratio was positively associated with IHD (ischemic heart disease) mortality and incidence. Adjustment for potential socioeconomic and behavioral confounding variables had little influence on these associations, but they appeared to be mediated by components of the insulin resistance syndrome (elevated blood pressure, triglyceride levels, body mass index, total cholesterol, HDL cholesterol, and impaired glucose tolerance). This suggests that methods of reducing the cortisol:testoterone ratio may improve insulin resistance and reduce the risk of ischemic heart disease (IHD). But, it does not suggest that reducing stress can reduce the risk of diabetes.
More conclusive research findings will be needed before we can conclude that stress does indeed lead to diabetes.
There are two major types of diabetes: type 1 diabetes mellitus and type 2 diabetes mellitus.
Type 1 diabetes mellitus is also known as juvenile diabetes because it starts in children and young adults. It is due to insufficient amount of insulin being produced (known as insulin deficiency). Since it does not start later in life, we can safely conclude that type 1 diabetes mellitus is unlikely to be caused by stress.
Type 2 diabetes mellitus usually occurs later in life, after the age of forty. Type 2 diabetes mellitus is the most common form of diabetes. In type 2 diabetes mellitus, the problems arise because
1. Either the body does not produce enough insulin, or
2. The insulin produced is ignored by the cells in the body (known as insulin resistance), or both.
Discussion on what insulin is and what the roles it plays is in order.
Insulin is a hormone that regulates carbohydrate metabolism (and to some extent fat metabolism as well). Insulin helps the body to use sugar. Sugar is the basic source of energy for the cells in the body, and insulin takes the sugar from the blood into the cells.
When we say blood sugar, we refer to glucose in the blood. Glucose is the main type of simple sugar in our blood. Our body needs to have glucose level controlled to within a narrow range (0.7-1.1 mg per ml). Below 0.7 mg per ml is termed "hypoglycemia", and above 1.8 mg per ml is termed "hyperglycemia". Both can result in problems as we shall see later.
When there is more glucose in the blood, more insulin is secreted into the blood, resulting in cells (muscle cells, red blood cells and fat cells) absorbing the glucose out of the blood, thus reducing the blood glucose level.
When there is less glucose in the blood, more glucagon (counter part of insulin) is secreted into the blood, stimulating liver to release the glucose it has stored in its cells into the blood stream, thus increasing blood glucose. Glucagon also induces the liver and some of the muscle cells to produce glucose out of protein.
If the glucose does not go into cells, instead it builds up in the blood, two problems arise. Firstly, if the cells do not get the glucose they need, they die. Secondly, prolong period of high blood glucose levels may hurt your eyes, kidneys, nerves or heart. Insulin is used to treat this "hyperglycemia" aspect of diabetes.
"Hypoglycemia" or low blood glucose level condition can happen when more insulin is introduced than there is food in the stomach to be acted on. This often happens when a patient injects insulin in anticipation of food consumption, but the food consumption is delayed or insufficient food is consumed. Symptoms of "hypoglycemia" include strange behavior, clumsy or jerky movements, seizure, confusion, tingling sensations around the mouth, dizziness, sweating, headache etc.
Now that we understand the mechanics of diabetes, is there anything to suggest that stress can cause diabetes (type 2)?
The usual reason explaining where stress lead to sickness is the weakening of our immunity system caused by stress. However, diabetes is not caused by weak immunity system.
Psychological stress caused by the death of a spouse, a financial crisis or other life-altering event has been associated with higher risk of developing diabetes in middle age. Many studies have shown that the abovementioned types of major life events were associated with type 2 diabetes regardless of family history of the disease, exercise or alcohol use. However, although such circumstantial evidence seems to suggest a link between a higher proportion of people under greater stress and diabetes, we cannot conclude that stress cause diabetes.
There is a theory that says that stressful life events increase the diabetes risk by increasing levels of the hormone cortisol and decreasing levels of sex steroids such as testosterone, which have been shown to influence the action of insulin.
Some researchers have tried to determine whether stress, which can be measured using the ratio cortisol:testosterone, affects insulin resistance. In the prospective study by George Davey Smith and colleagues from the University of Bristol in the United Kingdom, cortisol:testoterone ratio was positively associated with IHD (ischemic heart disease) mortality and incidence. Adjustment for potential socioeconomic and behavioral confounding variables had little influence on these associations, but they appeared to be mediated by components of the insulin resistance syndrome (elevated blood pressure, triglyceride levels, body mass index, total cholesterol, HDL cholesterol, and impaired glucose tolerance). This suggests that methods of reducing the cortisol:testoterone ratio may improve insulin resistance and reduce the risk of ischemic heart disease (IHD). But, it does not suggest that reducing stress can reduce the risk of diabetes.
More conclusive research findings will be needed before we can conclude that stress does indeed lead to diabetes.
About The Author Jacob Gan PhD (Michigan) has more than 20 years of teaching experience in a university and 8 years of business/industrial experience. He writes forhttp://succezz.com, http://JacobGan.com, http://JacobEducation.com andhttp://jacobLearning.com. |
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The Hidden Side of Type 2 Diabetes
Type 2 Diabetes continues to be in the headlines as a health crisis because more people are getting the disease and not enough of them are doing what it takes to minimize the complications that come with it. This is hard for those around them to understand. Friends, family and co-workers can’t grasp why it is so hard to get a healthier lifestyle if it means less suffering and pain. They wonder why those with cancer or other life-threatening diseases take action, while those facing diabetes seem stuck and unwilling to take better care of themselves. Are you one of those asking this question?
Unfortunately many of those at risk or who already have diabetes don’t understand it themselves. They don’t know why it is so hard to make changes or maintain better habits. It just is. But what so many of them do know is they feel misunderstood, frustrated and sick of dealing with the disease. The result is that millions of them simply give up trying and shut off their feelings, which leads to resignation and a denial of their situation.
I have worked with enough pre- and diagnosed type 2 diabetics (people with insulin resistance) struggling with lifestyle changes to understand their mental state, why it is so hard to take action and what can help them turn things around. And I will admit right up front that not everyone can be helped, but many can by understanding that diabetes is often a personal crisis for the individuals involved. They just can’t see it.
The typical person diagnosed with insulin resistance has not lived a healthy lifestyle, is often overweight, probably suffers from low self esteem (due to their weight, feeling out of control around food or other issues) and may be depressed. Upon diagnosis their life changes immediately. They must change the way they eat, monitor their carbohydrate intake and blood sugar levels throughout the day, and take an insulin sensitivity medication at specific times. The guidelines are very specific and rigid. They must also lose a certain amount of weight and given a deadline for when their blood sugar levels should get into the normal range. Many leave their appointments overwhelmed, in shock and frightened.
Initially people follow the guidelines fairly well and attempt to do what is asked of them, but it is a dramatic change from what they are accustomed to doing. As with dieting, they inevitably have days when it is too hard to do. This makes them feel guilty, believing they are bad and failing, further impacting their self esteem and depression. The more often this happens, the lower they feel. And the lower one’s self esteem or depression, the less likely they will take care of themselves. This becomes a downward spiral. If you have ever been depressed, you can appreciate this.
For most it is also challenging to comply with the exercise requirements. Many try, but it is tough to create a regular routine, especially if they’ve been sedentary. So despite their initial efforts to eat right and get exercise, the majority can’t keep it up and they discover something interesting. It doesn’t seem to make much difference in how they feel when they don’t exercise or eat so well. Sure their blood sugar levels go up or down too much, but it doesn’t seem so urgent or important when there aren’t obvious ramifications. What they can’t see or feel is the damage building up and the slippery slope of no return when they get past a certain point. But that can be several years from the initial diagnosis.
As an onlooker, what we see is their denial and refusal to do more. What they are actually experiencing is something far deeper: the repression of their emotions. They are dealing with feelings (many that contributed to their eating habits, lifestyle and diagnosis) such as shame, unworthiness, not being good enough or perfect enough. Add to that fear, stress, and all their other painful feelings that are pushed down and out of reach. Hiding beneath the surface is a personal crisis driving their behaviors.
The way to address it is with a non-judgmental approach to lifestyle intervention that is flexible and slowly rebuilds confidence through small goals and successes and provides a place for feelings to be released and beliefs to be changed. It can be done, but it may take about a year of weekly coaching and lots of patience. Even if they don’t believe it at first, those struggling with insulin resistance are worth it. This week reconsider what it is like to be struggling with this disease and understand that there is more than meets the eye.
Unfortunately many of those at risk or who already have diabetes don’t understand it themselves. They don’t know why it is so hard to make changes or maintain better habits. It just is. But what so many of them do know is they feel misunderstood, frustrated and sick of dealing with the disease. The result is that millions of them simply give up trying and shut off their feelings, which leads to resignation and a denial of their situation.
I have worked with enough pre- and diagnosed type 2 diabetics (people with insulin resistance) struggling with lifestyle changes to understand their mental state, why it is so hard to take action and what can help them turn things around. And I will admit right up front that not everyone can be helped, but many can by understanding that diabetes is often a personal crisis for the individuals involved. They just can’t see it.
The typical person diagnosed with insulin resistance has not lived a healthy lifestyle, is often overweight, probably suffers from low self esteem (due to their weight, feeling out of control around food or other issues) and may be depressed. Upon diagnosis their life changes immediately. They must change the way they eat, monitor their carbohydrate intake and blood sugar levels throughout the day, and take an insulin sensitivity medication at specific times. The guidelines are very specific and rigid. They must also lose a certain amount of weight and given a deadline for when their blood sugar levels should get into the normal range. Many leave their appointments overwhelmed, in shock and frightened.
Initially people follow the guidelines fairly well and attempt to do what is asked of them, but it is a dramatic change from what they are accustomed to doing. As with dieting, they inevitably have days when it is too hard to do. This makes them feel guilty, believing they are bad and failing, further impacting their self esteem and depression. The more often this happens, the lower they feel. And the lower one’s self esteem or depression, the less likely they will take care of themselves. This becomes a downward spiral. If you have ever been depressed, you can appreciate this.
For most it is also challenging to comply with the exercise requirements. Many try, but it is tough to create a regular routine, especially if they’ve been sedentary. So despite their initial efforts to eat right and get exercise, the majority can’t keep it up and they discover something interesting. It doesn’t seem to make much difference in how they feel when they don’t exercise or eat so well. Sure their blood sugar levels go up or down too much, but it doesn’t seem so urgent or important when there aren’t obvious ramifications. What they can’t see or feel is the damage building up and the slippery slope of no return when they get past a certain point. But that can be several years from the initial diagnosis.
As an onlooker, what we see is their denial and refusal to do more. What they are actually experiencing is something far deeper: the repression of their emotions. They are dealing with feelings (many that contributed to their eating habits, lifestyle and diagnosis) such as shame, unworthiness, not being good enough or perfect enough. Add to that fear, stress, and all their other painful feelings that are pushed down and out of reach. Hiding beneath the surface is a personal crisis driving their behaviors.
The way to address it is with a non-judgmental approach to lifestyle intervention that is flexible and slowly rebuilds confidence through small goals and successes and provides a place for feelings to be released and beliefs to be changed. It can be done, but it may take about a year of weekly coaching and lots of patience. Even if they don’t believe it at first, those struggling with insulin resistance are worth it. This week reconsider what it is like to be struggling with this disease and understand that there is more than meets the eye.
About The Author Alice Greene, founder of Feel Your Personal Best, is a Healthy Lifestyle Coach, who has helped many people feel great. Alice is co-host of Living Your Personal Best radio show. She provides a unique perspective on how to succeed at making lifestyle changes that facilitate making all your life dreams come true. Sign up for her free report, "9 Life-Changing Secrets Every Woman Must Know" and confirm what you already know deep in your soul to be true. Ignite something in you that changes your perception of yourself and gives you permission to put self care on equal par with the other priorities in your day and week. To receive your free copy, visithttp://www.feelyourpersonalbest.com. |
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