Effect of psychological stress on glucose control in patients with Type 2 diabetes

Faulenbach, Mirjam; Uthoff, Heiko; Schwegler, Kyrill; Spinas, G A; Schmid, Christoph; Wiesli, Peter

doi:10.1111/j.1464-5491.2011.03431.x

Cited by 75 publications

(71 citation statements)

References 6 publications

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“…On the other hand, NNT deficiency had the opposite effect; with very little CORT secretion because of adrenal cortex dysfunction (31), NNT deficiency was associated with severe hyperglycemia. Peripheral insulin resistance and impaired insulin secretion likely contribute to this effect (29,33) and could explain why psychological stress during the Trier social stress test (TSST) in humans preferentially favors hyperglycemia in those with preexisting diabetes and insulin resistance (49). Furthermore, stress-related cortisol levels also exhibit racial and ethnic differences (50), although the underlying mechanisms remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Mitochondrial functions modulate neuroendocrine, metabolic, inflammatory, and transcriptional responses to acute psychological stress

Picard

McManus

Gray

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

235

155

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The experience of psychological stress triggers neuroendocrine, inflammatory, metabolic, and transcriptional perturbations that ultimately predispose to disease. However, the subcellular determinants of this integrated, multisystemic stress response have not been defined. Central to stress adaptation is cellular energetics, involving mitochondrial energy production and oxidative stress. We therefore hypothesized that abnormal mitochondrial functions would differentially modulate the organism's multisystemic response to psychological stress. By mutating or deleting mitochondrial genes encoded in the mtDNA [NADH dehydrogenase 6 (ND6) and cytochrome c oxidase subunit I (COI)] or nuclear DNA [adenine nucleotide translocator 1 (ANT1) and nicotinamide nucleotide transhydrogenase (NNT)], we selectively impaired mitochondrial respiratory chain function, energy exchange, and mitochondrial redox balance in mice. The resulting impact on physiological reactivity and recovery from restraint stress were then characterized. We show that mitochondrial dysfunctions altered the hypothalamicpituitary-adrenal axis, sympathetic adrenal-medullary activation and catecholamine levels, the inflammatory cytokine IL-6, circulating metabolites, and hippocampal gene expression responses to stress. Each mitochondrial defect generated a distinct whole-body stressresponse signature. These results demonstrate the role of mitochondrial energetics and redox balance as modulators of key pathophysiological perturbations previously linked to disease. This work establishes mitochondria as stress-response modulators, with implications for understanding the mechanisms of stress pathophysiology and mitochondrial diseases. stress reactivity | mitochondria | HPA axis | catecholamines | hippocampus R epeated exposure to psychological stress can predispose to disease (1, 2). The underlying mechanisms involve dysregulation of peripheral stress response elements including the hypothalamic-pituitary-adrenal (HPA) axis and glucocorticoids (3), the sympathetic adrenal-medullary (SAM) axis and catecholamines (4), systemic inflammation (5), and the "diabetic-like" state of excess circulating glucose and lipids (i.e., metabolic oversupply) promoted by stress hormones (6, 7). In addition, stress leads to neuronal remodeling, which involves changes in brain gene expression, particularly within the hippocampus (8, 9). However, the subcellular factors that modify these systemic responses to stress have not been defined. The objective of this study was to determine if mitochondria mediate physiological stress responses in mice.Mitochondria are symbiotic organelles that contain their own genetic material, the mtDNA, which encodes essential subunits of the respiratory chain complexes I, III, IV, and V. At complex I, electrons derived from energetic substrates (glucose and lipids) enter the respiratory chain and travel to complex IV, where they are combined with oxygen to produce energy in the form of ATP required for life (10). ATP generated inside mitochondria then is ex...

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Section: Discussionmentioning

confidence: 99%

Mitochondrial functions modulate neuroendocrine, metabolic, inflammatory, and transcriptional responses to acute psychological stress

Picard

McManus

Gray

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

235

155

View full text Add to dashboard Cite

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“…[11][12][13] Because the current study assessed only 1 global daily measure of stress, it was not possible to investigate relationships between stress and discrete glycemic responses at different times of the day in relation to meals. However, there was a relationship between higher stress and decreased daily carbohydrate consumption, although these findings may also indicate decreased entry of carbohydrate data on higher stress days, or increased consumption of low-carbohydrate foods.…”

Section: Discussionmentioning

confidence: 99%

Is Psychological Stress a Factor for Incorporation Into Future Closed-Loop Systems?

Gönder-Frederick

Grabman

Kovatchev

et al. 2016

J Diabetes Sci Technol

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It has long been recognized that acute psychological stress may affect blood glucose (BG) levels in type 1 diabetes (T1DM) through both direct and indirect mechanisms.1-3 The direct impact is mediated by stress-induced activation of adrenergic hormones and cortisol, which can increase glucose production and increase insulin resistance.3-5 Indirect effects can occur secondary to stress-related deterioration in diabetes management behaviors such as under-or over-eating, checking BG less often, and skipping exercise. In spite of these recognized mechanisms, the glycemic impact of acute stress in T1DM has proven difficult to demonstrate. Laboratory studies have yielded inconclusive results, with some studies finding no stress effect, 6,7 and other studies finding increases in BG for some people and decreases in BG for others, in response to the same stressful situation. Abstract Background: The relationship between daily psychological stress and BG fluctuations in type 1 diabetes (T1DM) is unclear. More research is needed to determine if stress-related BG changes should be considered in glucose control algorithms. This study in the usual free-living environment examined relationships among routine daily stressors and BG profile measures generated from CGM readings.

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“…Hasil ini berbeda dengan penelitian yang menyebutkan bahwa lebih dari 50 persen pasien kronis mengalami stres ringan sampai sedang (Sandra, et al, 2012;Sofiana, et al, 2012). Kondisi responden pada penelitian ini baik mengingat beberapa studi sebelumnya menyebutkan bahwa stres psikologis dapat meningkatkan konsentrasi gula darah pada pasien diabetes mellitus tipe 2 (Faulenbach, et al, 2012;Lloyd, Smith, & Weinger, 2005). Wiesli, et al (2005) bahkan melaporkan bahwa pada pasien diabetes mellitus tipe 1, kondisi stress psikologis memperlambat penurunan gula darah selepas mendapat asupan makanan tetapi pada kondisi puasa tidak ditemukan gejala apapun.…”

Section: Pembahasanunclassified

Kemampuan Spiritualitas Dan Tingkat Stres Pasien Diabetes Mellitus Di Rumah Perawatan: Studi Pendahuluan

Suciani¹,

Nuraini

2017

Jurnal Keperawatan Indonesia

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AbstrakSpiritualitas merupakan salah satu hal yang terpenting dalam hidup seseorang, termasuk bagi pasien diabetik. Spiritualitas digambarkan sebagai pengalaman yang paling tinggi, hubungan yang lebih mendalam yang dirasakan terhadap Tuhan, sesama, termasuk terhadap alam. Studi pendahuluan ini bertujuan mengidentifikasi hubungan antara kemampuan spiritualitas dan tingkat stres pasien diabetes yang melakukan perawatan luka di rumah perawatan. Penelitian potong lintang ini melibatkan sampel sebanyak 64 responden pasien diabetes di rumah perawatan di wilayah Jabodetabek, dengan teknik consecutive sampling. Instrumen yang digunakan adalah modifikasi dari Multidimensional Measure of Religiousness/Spirituality, Spiritual Involvement and Belief Scale Revised Version, Spiritual Health, and Life-Orientation Measure dan kuesioner Depression Anxiety Stress Scales (DASS). Hasil penelitian menujukkan bahwa tidak terdapat hubungan yang signifikan (p= 0,219; p< 0,05) antara kemampuan spiritualitas dan tingkat stres, namun secara klinis penelitian ini cukup bermakna karena responden dengan tingkat stres normal memiliki rerata kemampuan spiritualitas yang lebih tinggi dibanding kategori lainnya. Studi lanjutan perlu dilakukan untuk menguji hubungan factor lainnya terhadap kemampuan spiritual dan tingkat stress. Kemampuan spiritualitas pasien diabetik ini perlu lebih diperhatikan oleh seorang perawat ketika memberikan asuhan keperawatan pada pasien diabetikum sehingga dapat menunjang aspek lainnya yang berkontribusi dalam kemampuan perawatan diri pasien. PendahuluanPenyakit diabetes mellitus adalah penyakit kronis progresif yang ditandai dengan ketidakmampuan tubuh untuk melakukan metabolisme karbohidrat, lemak, dan protein, mengarah ke hiperglikemia atau kadar glukosa darah yang tinggi (Black & Hawks, 2008.

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Effect of psychological stress on glucose control in patients with Type 2 diabetes

Abstract: When stress is experienced in the postprandial period, acute psychological stress significantly increases glucose concentrations in patients with Type 2 diabetes.

Cited by 75 publications

References 6 publications

Mitochondrial functions modulate neuroendocrine, metabolic, inflammatory, and transcriptional responses to acute psychological stress

Mitochondrial functions modulate neuroendocrine, metabolic, inflammatory, and transcriptional responses to acute psychological stress

Is Psychological Stress a Factor for Incorporation Into Future Closed-Loop Systems?

Kemampuan Spiritualitas Dan Tingkat Stres Pasien Diabetes Mellitus Di Rumah Perawatan: Studi Pendahuluan

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