Stress: Latent factor for Developing Complications of Diabetes

sanjida_akter_suchana

Stress is a common word in our daily life. There are different sources of stress. These may be physical, mental or like injury or illness. Due to the stress, the body will become prepare to take action against it. This action is called ‘Fight or flight’ action. Most of the people think that diabetes is only caused by the imbalanced production of insulin or from genetically problem. But stress may play a vital role in developing diabetes.

The Autonomic Nervous System (ANS) is concerned with the regulation of cardiac muscle, smooth muscle and glands. This system is also responsible for regulating the functions over which there is no conscious control including cardiovascular function, metabolism and digestion. Two parts of the composition of ANS are the parasympathetic and the sympathetic nervous system.

The Sympathetic Nervous System is the most dominant part in times of stress which is involved with the preparation of the body for action. It increases oxygen and nutrient supplies to the muscles which is achieved by the increase of the blood flow to the skeletal muscles. Glucose and lipids are also released from their stores. The immune system is also prepared by this system to deal with possible injury. In the response against stress, many hormones are released in the body or the levels of hormones shoot up. In case of diabetic patients, this response does not work well.

Insulin is not always able to let the extra energy into the cells. As a result, the level of glucose will be elevated in the body. In diabetic patients, blood glucose levels can be altered by stress in 2 ways: the first one is, people under stress cannot take good care of themselves or they may consume alcohol or exercise less. The second one, stress hormones are released in stressful condition which can directly alter blood glucose level.

These stress hormones have also the ability to make the body resistant to insulin. Several laboratory studies are conducted in order to demonstrate the effects of specific stressful situations on blood glucose level. These types of stress may destabilize blood glucose level for at least hours at a time. The behavioral mechanisms by which stressful experiences can affect control of Diabetes are varied. At the same time, there are many differences in resources including social supports, other psycho social variables and ability to cope. Reactions to external stress can lead to difficulties with self-care manifested through reduced physical activity, imbalanced diet or difficulties with taking medications. The reactions may include anxiety or depression.

Other unhealthy behaviors can be resulted from experiences of stress including smoking, alcohol and tobacco consumption. Smoking can increase the risk of poor blood glucose control. Researchers also found that stress and coping may affect glycemic control through interference with self-care practices.

Depression and diabetes-related distress often happen together. These may have serious implications for diabetes management as those affected might feel unable or unmotivated to carry out self-care behaviors like blood glucose testing or healthy eating. Many long-term sources of stress are mental. Mental stress is common in the young generation due to their study, future plan or career development and may be other facts.

Therefore, they should be aware of this. Most of the mental stresses can be reduced by changing the daily life. This may be achieved by doing exercise, refreshments, outing with family and friends etc. Sometimes, depression can be resulted from mental stress. The depressed people lose their hope in most of the cases. As a result, their appetite and interest in doing any type of activities are decreased. These people are at higher risk of developing diabetes.

Sanjida Akter Suchana is an postgraduate student of Department of Clinical Pharmacy and Molecular Pharmacology, East West University, Bnagladesh. She has interest in wet lab based research in pharmaceutical science. Recently she is serving as Graduate Teaching Assistant.  She can be reached at sanjida.suchana@yahoo.com

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