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Does Stress Increase The Risk Of Type 2 Diabetes?
By: Patrick Mansfield | U.S. Health Alerts

Stress And Diabetes

Type 2 diabetes is a common disease throughout the world but a persistent mystery is why it occurs more often in some ethnicities than others. While the risk for whites in the United States developing type 2 diabetes in their lifetime is 1 in 3, this number jumps to 1 in 2 for African Americans and Latinos. 

Previously, genes were thought to be the root cause of this noticeable difference. Additional factors such as dietary choices, exercise, and family history have also been examined for their potential role in type 2 diabetes. 

Increasing evidence is pointing to the potential impact of the environment, stress and type 2 diabetes risk. Factors such as discrimination and poverty, unfortunate issues that certain populations deal with more than others, may result in a physical toll. Exercise physiologist Rebecca Hasson, PhD, director of the Childhood Disparities Research Laboratory at the University of Michigan, states, “There’s substantial evidence to demonstrate the environment we live in has direct impacts on our health,”.

Cortisol may be responsible for the link between stress and type 2 diabetes. “Cortisol is a biomarker of stress,” Hasson says. This hormone, part of the "fight or flight" response, released during periods of stress to help supply the body with more energy, is to blame for a host of reactions in the body including: 
  • Directs cells to ignore insulin's signals
  • Initiates cravings for high-calorie food
  • Increases blood glucose levels
Cortisol's actions are beneficial in short-lived situations, such as escaping an attack by a wild animal. The issue occurs when other circumstances prompt the release of this hormone. “Those energy substrates are mobilized so you can run away,” Hasson says. “But if you don’t, or can’t run away—you’re late for school, someone’s pointing a gun at you, you can’t pay your bills—you’re always in this high-alert situation, whether or not you’re conscious of it.”

If cortisol levels remain high without efficient exercise to counteract the chronic stress, the result may be an increased risk of type 2 diabetes. Higher cortisol levels lead to increased insulin resistance thereby forcing the pancreas to produce higher amounts of insulin in order to elicit a response. Over time, this causes the cells responsible for producing insulin to wear out and results in type 2 diabetes. 

If chronic stress makes people sick, are blacks and Latinos more sick due to increased levels of stress? Since statistics show these groups are more likely to be poor or reside in poor neighborhoods, they are at an increased risk of experiencing chronic stressors, such as poverty or discrimination, as well as the negative side effects of these issues. “Overall," Hasson states, "ethnic minorities have much higher cortisol levels and exposure than whites,”.

Thanks to a grant from the American Diabetes Association along with funds from the Prince Hall Shriners, Hasson is measuring links between race, stress, and type 2 diabetes risk directly within a group of 150 obese children. These children, all between the teenage years of 14 and 18, are a “perfect biological and social storm" according to Hanson, due to their overlapping issues with school, family, and day to day stresses along with out of control hormones. 

A portion of the study aims to discover the reasons participants may feel stressed, whether due to family income, diet, family life, or any discrimination they may experience. 

Since teen's self-reports of stress levels may not always be reliable, Hasson also asks members of the study to spit in a test tube 5 times per day in order to accurately measure the presence of cortisol in saliva. “You can’t rely on somebody’s perception of stress in their life. Kids exposed to a lot of stress underreport,” she says.

All in all, Hasson discovered that, in the studies, African American and Latino children had higher levels of cortisol. By continuing to monitor these children, she hopes to learn if their cortisol levels and other stress markers are linked to increased occurrences of type 2 diabetes. “If there are ethnic differences in the stress pathways, that could help guide our intervention,” Hasson states. "We’d have to start asking ourselves how we can reduce stress in their lives.”
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