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Cited by 400Diabetes Management and ResearchStress Responses and CortisolPancreatic function and diabetes

Stress and Diabetes Mellitus

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Surwit, Richard S, Schneider, Mark S, Feinglos, Mark N·1992·Diabetes Care
DOI 10.2337/diacare.15.10.1413
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Abstract

Stress is a potential contributor to chronic hyperglycemia in diabetes. Stress has long been shown to have major effects on metabolic activity. Energy mobilization is a primary result of the fight or flight response. Stress stimulates the release of various hormones, which can result in elevated blood glucose levels. Although this is of adaptive importance in a healthy organism, in diabetes, as a result of the relative or absolute lack of insulin, stress-induced increases in glucose cannot be metabolized properly. Furthermore, regulation of these stress hormones may be abnormal in diabetes. However, evidence characterizing the effects of stress in type I diabetes is contradictory. Although some retrospective human studies have suggested that stress can precipitate type I diabetes, animal studies have shown that stressors of various kinds can precipitate—or prevent—various experimental models of the disease. Human studies have shown that stress can stimulate hyperglycemia, hypoglycemia, or have no affect at all on glycemic status in established diabetes. Much of this confusion may be attributable to the presence of autonomic neuropathy, common in type I diabetes. In contrast, more consistent evidence supports the role of stress in type II diabetes. Although human studies on the role of stress in the onset and course of type II diabetes are few, a large body of animal study supports the notion that stress reliably produces hyperglycemia in this form of the disease. Furthermore, there is mounting evidence of autonomic contributions to the pathophysiology of this condition in both animals and humans.

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Crossref · 10.2337/diacare.15.10.1413

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61 of 61 references verified0 citation errors · 0 not checkable

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  • A large body of animal research supports the notion that stress enhances the state of hyperglycemia in diabetes.

    “Although human studies on the role of stress in the onset and development of diabetes are few, a large body of animal research supports the notion that stress enhances the state of hyperglycemia in this disease [4].”

    From A mathematical model of brain glucose homeostasis (2009) · cites this paper as [4]

    The Abstract says a large body of animal research supports stress-induced hyperglycemia in type II diabetes. The citing sentence broadens that finding to diabetes generally, but the paper describes the animal evidence for type I diabetes as dependent on the stressor and model, with no clear overall conclusion (STRESS AND GLUCOSE CONTROL IN TYPE II DIABETES). Page numbers were not supplied. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Stress reliably induces hyperglycemia in diabetes.

    “Although human studies on the role of stress on the onset and course of diabetes are limited, a large body of evidence based on animal studies supports the notion that stress reliably induces hyperglycemia in diabetes [4].”

    From A mathematical model of brain glucose homeostasis (2009) · cites this paper as [4]

    The Abstract says animal studies support reliable stress-induced hyperglycemia in type II diabetes. The citing sentence retains the animal-study qualifier but broadens the finding to diabetes generally; the same section says evidence for type I diabetes is contradictory. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • Although human studies on the role of stress on the onset and course of diabetes are limited, the notion that stress reliably produces hyperglycemia in disease has been supported by animal studies.

    “Although human studies on the role of stress on the onset and course of diabetes are limited, the notion that stress reliably produces hyperglycemia in disease has been supported by animal studies [4].”

    From A mathematical model of brain glucose homeostasis (2009) · cites this paper as [4]

    The Abstract says human studies are few and animal studies support reliable stress-induced hyperglycemia specifically in type II diabetes. The claim omits that restriction and applies the finding to diabetes generally; the Abstract describes evidence for type I diabetes as contradictory. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • The stress-simulation results compared well with clinical knowledge concerning the stress-induced hyperglycemia in diabetes.

    “The stress-simulation results compared well with clinical knowledge concerning the stress-induced hyperglycemia in diabetes [4].”

    From A mathematical model of brain glucose homeostasis (2009) · cites this paper as [4]

  • Psychological and social problems can impair the individual's or family's ability to carry out diabetes care tasks and therefore compromise health status.

    “Psychological and social problems can impair the individual's (133–138) or family's (139) ability to carry out diabetes care tasks and therefore compromise health status.”

    From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [136]

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Cites

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Research works printed but not linked: 5

  1. Williams RH, Ed. Philadelphia, PA, Saunders, 1974, p. 502-626
  2. Landsberg L, Young JB: Sympathoadre- nal system: the regulation of metabolism. In Contemporary Endocrinology. Vol. 2. Ingbar SH, Ed. New York, Plenum, 1985, p. 217-46
  3. Guillemin R: Hypothalamus, hormones and physiological regulation. In Claude Bernard and the Internal Environment: A Memorial Symposium. Debbs-Robin E, Ed. New York, Dekker, 1978, p. 137-56
  4. Travis L, Brouhard BH, Schreiner BD, Eds. Philadelphia, PA, W. B. Saunders, 1987, p. 137-46
  5. Woods SC, Smith PH, Porte D: The role of the nervous system in metabolic reg- ulation and its effects on diabetes and obesity. In Handbook of Diabetes Mellitus. Vol. 3. Brownless M, Ed. New York, Gar- land, 1981, p. 208-71

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Authors
Surwit, R. S., Schneider, M. S., & Feinglos, M. N.
Affiliations
Duke Medical Center (US)
ORCID
Schneider, Mark S
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
1992-10-01
Volume
15
Issue
10
Pages
1413-1422
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.15.10.1413
OpenAlex
W2127658779
Semantic Scholar
1955c63cb0a11e7db5ca716b610975f161727b9b
Cited by
400
References
60
Citations by year
2026: 11 · 2025: 56 · 2024: 27 · 2023: 22 · 2022: 14 · 2021: 24 · 2020: 9 · 2019: 21 · 2018: 9 · 2017: 11 · 2016: 10 · 2015: 15 · 2014: 12 · 2013: 9 · 2012: 11
FWCI
1.13
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute of Mental Health (K02MH000303)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK043106, R01DK042923)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Keywords
stress, diabetes mellitus, type 1 diabetes, type 2 diabetes, hyperglycemia, fight-or-flight response, stress hormones, insulin deficiency, autonomic neuropathy
MeSH terms
Animals, Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Humans, Mice, Obese, Stress, Physiological, Stress, Psychological, Mice

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