Cited by 116Stress Responses and CortisolAdipokines, Inflammation, and Metabolic DiseasesAdrenal Hormones and Disorders

Chronic Stress and Diabetes Mellitus: Interwoven Pathologies

Sharma, Vivek Kumar, Singh, Thakur Gurjeet·2020·Current Diabetes Reviews

Abstract

Stress threatens the homeostasis and mobilizes a plethora of adaptive physiological and behavioral changes via the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system. The HPA axis influences the pituitary gland, hypothalamus and adrenal gland via a complex set of positive and negative feedback system. The feedback system operates in a well regulated neuroendocrine manner to reestablish the threatened body equilibrium. The HPA axis secreted major product is a glucocorticoid (cortisol) which is kept within a physiologically optimal range and serves to accomplish the various physiological functions crucial for survival. In chronically stressed individuals dishabituation of HPA axis is followed by increased release of glucocorticoids and catecholamines. Higher secretion of glucocorticoids influences glucose metabolism by promoting gluconeogenesis in the liver, suppressing glucose uptake (adipocytes and skeletal muscles), promoting lipolysis in adipocytes, suppressing insulin secretion, inflicting insulin resistance and inflammation. These biological changes alter neuroendocrine mechanisms and lead to maladaptive congregation of events that form the underlying cause of development of Type 2 diabetes (T2D). The currently reviewed evidences advocate that targeting stress mediated hypersecretion of glucocorticoids may be a viable approach for the treatment of T2D and to reinstate glucose homeostasis.

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Crossref · 10.2174/1573399815666191111152248

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  • Cortisol, with a primary role in stimulating gluconeogenesis, might be understood to be a metabolic rather than a 'stress' hormone.

    “Cortisol, with a primary role in stimulating gluconeogenesis, might be understood to be a metabolic rather than a 'stress' hormone.228,229”

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Authors
Sharma, V. K., & Singh, T. G.
Affiliations
Chitkara University (IN)
Corresponding author
Singh, Thakur Gurjeet
Venue
Current Diabetes Reviews
Published
2020-06-14
Volume
16
Issue
6
Pages
546-556
ISSN
1573-3998 (ISSN-L)
OpenAlex
W2985311368
Cited by
116
References
119
Citations by year
2026: 12 · 2025: 27 · 2024: 23 · 2023: 23 · 2022: 20 · 2021: 8 · 2020: 3
FWCI
0.90
Type
journal article
Language
en
Open access
closed
Locations
  • Current Diabetes Reviews (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
chronic stress, type 2 diabetes, hypothalamic-pituitary-adrenal axis, glucocorticoids, cortisol, insulin resistance, glucose metabolism, gluconeogenesis, sympathetic nervous system, catecholamines, neuroendocrine feedback, inflammation, glucose homeostasis
MeSH terms
Chronic Disease, Diabetes Mellitus, Type 2, Glucocorticoids, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Insulin Resistance, Stress, Physiological, Stress, Psychological, Sympathetic Nervous System

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