Stress, Behavior, and the Autonomic Nervous System in Type II Diabetes Mellitus

Abstract

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 a variety of hormones which can result in elevated blood glucose levels. While this is of adaptive importance in a healthy organism, in diabetes, due to a relative or absolute lack of insulin, stress-induced increases in glucose cannot be properly metabolized. Furthermore regulation of these stress hormones is abnormal in diabetes. Thus, stress is a potential contributor to chronic hyperglycemia in this disease although its exact role is unclear. The role of stress in Type II diabetes is of particular importance because, in contrast to Type I diabetes, the pathophysiology of Type II diabetes remains obscure. In this chapter we will review the literature on the effects of stress on hyperglycemia in Type II diabetes and evaluate the possible role of the autonomic nervous system and behavior in the etiology and course of this disease.