Stress and Diabetes Mellitus: Pathogenetic Mechanisms and Clinical Outcome

Evidence suggests that psychological and physical stress are relevant triggering factors for the onset of type 1 diabetes (T1D) and type 2 diabetes (T2D). The underlying mechanisms involve a complex neuroendocrine structure, involving the central nervous system and the periphery. Psychological stress leads to an increase of serum glucocorticoid concentrations and catecholamines release increasing the insulin need and the insulin resistance. According to the beta-cell stress hypothesis, also causes of increased insulin demand, such as rapid growth, overweight, puberty, low physical activity, trauma, infections, and glucose overload, are potentially relevant factors in development of T1D. It has also been demonstrated that chronic stress and obesity form a vicious circle which leads to a definitive metabolic failure, increasing the risk of developing T2D. In this review, we will provide the most recent data concerning the role of stress in the outcomes of T1D and T2D, with a focus on the role of physical and psychological stress on the onset of T1D.

Automated summary

Psychological and physical stress play a role in triggering the onset of both type 1 diabetes (T1D) and type 2 diabetes (T2D). These stresses lead to changes in hormone levels that affect insulin production and insulin resistance. Other factors, such as rapid growth, obesity, puberty, low physical activity, trauma, infections, and glucose overload, are also potential causes of increased insulin demand and are relevant in the development of T1D. Chronic stress and obesity create a cycle that can lead to metabolic failure and increase the risk of developing T2D.