Effect of Stress on Glucose Metabolism
Diabetes mellitus is a set of disorders that share common insufficiency in the regulation of carbohydrate metabolism. The term diabetes mellitus refers to the sweet tang urine of patients with the disease, a symptom first described by Areteus over 2000 years ago. Stress has long been suspected as a prime cause of metabolic disarray. Stress impairs glucose metabolism by discharging a host of ‘counter-regulatory’ hormones that result in declined insulin activity and elevated blood glucose levels.
Stress has an energy mobilizing effect on a healthy organism. However, in patients suffering from diabetes, due to relative or absolute lack of insulin, stress provoked high blood glucose cannot be adequately metabolized. Thus, stress is a potential contributor to chronic hyperglycemia in diabetes. Bjorntorp (1991) suggested that this mechanism may lead to both central obesity and a predisposition to diabetes. Stress initiated discharge of growth hormone and beta-endorphin can also reduce glucose uptake, restrain insulin secretion and raise glucose levels. There are vagal afferents form the liver to the central nervous system and brain receptors for numerous peptide hormones originally found in gut. The adaptive benefit of the mechanism of stress-induced energy mobilization in healthy individuals is evident, but in diabetic individuals, where glucose metabolism is on stake, the mechanism may be complicated.