Stress and Diabetes Flashcards
What is diabetes and what are its complications?
-Diabetes mellitus (DM): a disorder caused by problems with insulin production or action, leading to high blood sugar.
-Pancreas dysfunction: affects insulin release and glucose metabolism.
-complications: nervous system issues, blindness, kidney disease, amputation, sexual dysfunction.
What is Diabetes Mellitus Type 1 (DMI) and how does it affect the body?
-Type 1 diabetes (DMI): autoimmune disease where the body destroys beta cells in the pancreas, preventing insulin production.
-develops rapidly in childhood or adolescence, or progressively in adulthood as latent autoimmune diabetes.
-symptoms: increased thirst, frequent urination, blurred vision, weight loss, slow wound healing, fatigue.
-treatment: insulin injections required for survival.
-risks: too much insulin can cause hypoglycemia, leading to coma or death.
What is Diabetes Mellitus Type 2 (DM2) and how does it affect the body?
-Type 2 diabetes (DM2): Insulin resistance; body’s insulin is not effectively used.
-pancreas produces insulin but insufficient to meet high blood glucose demands.
-lifestyle changes and insulin support required.
-can lead to insulin dependence over time.
-symptoms: thirst, frequent urination, tiredness, blurred vision, slow healing.
-risk factors: Often linked to being overweight.
-common in: Over 40s (white population), over 25 (South Asian population).
How does the sympathetic nervous system (SNS) response affect diabetes?
-SNS activation triggers adrenal medulla to release epinephrine and norepinephrine.
-Fight or flight response: insulin secretion decreases in the pancreas; liver releases glucose into the bloodstream for quick energy.
-issue in diabetes: in insulin-resistant or insulin-deficient states, the excess glucose can cause complications.
How does the HPA axis affect diabetes?
-HPA axis activation: pituitary gland releases ACTH, then Adrenal cortex produces cortisol (glucocorticoids).
-chronic stress: prolonged cortisol exposure can block insulin action. This contributes to high blood glucose levels.
How does cortisol affect diabetes?
-cortisol increases blood glucose levels, leading to hyperglycemia.
-even with normal/elevated insulin, glucose can’t be taken up by cells due to cortisol’s blocking effect.
-higher HPA axis activation is linked to chronic diabetes complications like neuropathy, retinopathy, and macroangiopathy
-depressed immune system: cortisol increases susceptibility to autoimmune diseases, potentially triggering Type 1 diabetes.
What role does family history play in the development of diabetes?
-Type 1 Diabetes: 50% concordance in twin studies (genetic factors play a role, but environmental factors are also important).
-Type 2 Diabetes: almost 100% concordance in monozygotic twins; even twins in different environments or with different weights are concordant for Type 2 Diabetes; genetic factors significantly influence the incidence and severity of Type 2 Diabetes, alongside lifestyle factors.
How does stress affect glucose tolerance in rats with Type 2 Diabetes?
-Glucose tolerance test: mice given a sugary drink, with blood glucose measured over the next 2 hours.
-stressed mice showed much higher and sustained glucose levels compared to non-stressed mice, indicating an impaired ability to process glucose.
-conclusion: stress impairs the body’s ability to handle glucose, contributing to Type 2 Diabetes.
How do environmental stressors affect Type II Diabetes and what is the prevalence?
-different types of stress negatively affect blood sugar regulation (glycemic control) in diabetic patients.
-stress interferes with dietary and treatment compliance, worsening diabetes management.
-genetic factors and environmental factors both contribute to the development of Type II Diabetes.
-affects 34% of American adults aged 20 or over; 57 million individuals in the U.S. are at serious risk for Type II Diabetes.
-[Stress often leads to poorer health behaviors, which can worsen diabetes outcomes.]
How do dietary factors influence Type II Diabetes and can this be changed?
-Type 2 diabetes and obesity are linked epidemics, with a linear correlation between eating patterns and diabetes development.
-Western diet includes red meat, refined carbohydrates, sweets, and full-fat dairy products.
-type of fat matters: saturated fats increase insulin insensitivity.
-The Diabetes Prevention Program reduced diabetes by 58% through lifestyle changes.
-The Da Qing Study showed a 43-67% reduction in diabetes risk after a 6-year lifestyle intervention.
How is burnout associated with the risk for Type II diabetes?
-burnout is linked to a significantly higher risk (1.84) of developing Type II diabetes in healthy workers.
-workers with high burnout have a much higher incidence of Type II diabetes compared to low burnout workers.
-age, family history, alcohol and drug intake, reduced physical activity, and hypertension were controlled for in the study.
How does poverty affect the risk of developing Type II Diabetes in African American women?
-African American women living in poverty are at a greater risk for developing Type II diabetes
-contributing factors: healthier food is more expensive, and stress due to lack of resources play a role
-Conservation of Resources (COR) Theory: those with fewer resources experience more stress during losses, as they have fewer resources to fall back on. Each loss decreases coping resources, leading to greater risk of future losses.
-increased stress and lack of resources contribute to poor health outcomes, including a higher risk for Type II diabetes.
How does social stigma affect individuals with obesity and Type II Diabetes?
-obesity is often seen as something within the individual’s control.
-leads to daily stress and feelings of blame, guilt, and helplessness.
-stress and negative emotions can impair diabetes management.
-this stress leads to a circular cycle of depression and poor lifestyle choices, further exacerbating the condition.
How does psychological stress affect blood glucose levels in individuals with a genetic predisposition to Type II Diabetes (Pima Indians)?
-10-minute mental arithmetic test was used to induce stress.
-Pima Indians showed an increase in blood glucose levels due to stress.
-control group (white subjects) did not experience an increase in glucose levels.
-both groups showed similar cardiovascular and neuroendocrine responses to the stressor
How is depression associated with the development and progression of Type II Diabetes?
-clinically significant depression is associated with a 60-65% increased risk of Type II Diabetes
-depression is a common co-morbid condition among adults with diabetes.
-psychotropic medications can cause weight gain, which increases the risk of developing Type II Diabetes.
-depression leads to abnormal HPA axis functioning, which contributes to glucose dysregulation.
-depression is linked to poorer glycemic control and increased cardiovascular disease risk in people with diabetes.
What is the depression-diabetes cycle?
-depression → psychotropic medications & glucose dysfunction → diabetes → depression → poor glycemic control → increased diabetes severity and complications → back to depression.
How does stress management affect Type II Diabetes management?
-patients with Type 2 diabetes were randomized to receive either a diabetes education program with or without stress management training.
-stress management training led to a 0.5% reduction in HbA1c (glycated hemoglobin), a marker for blood glucose levels.
-this reduction is considered significant as it lowers the risk of microvascular complications.
-the results were significant at a one-year follow-up.
