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

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Chronic Stress and Diabetes Mellitus: Interwoven Pathologies

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

DOI 10.2174/1573399815666191111152248

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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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Authors: Sharma, V. K., & Singh, T. G.
Affiliations: Chitkara University (IN)
Corresponding author: Singh, Thakur Gurjeet
ORCID: Sharma, Vivek Kumar
Singh, Thakur Gurjeet
Venue: Current Diabetes Reviews
Publisher: Bentham Science Publishers Ltd.
Published: 2020-06-14
Volume: 16
Issue: 6
Pages: 546-556
ISSN: 1573-3998 (ISSN-L)
DOI: 10.2174/1573399815666191111152248
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 › Endocrinology, Diabetes and Metabolism › 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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