Could STRESS give you diabetes?

Research published in the journal Psychosomatic Medicine last September found that those under extreme pressure at work were 45 per cent more likely to develop type 2 diabetes than those under minimal pressure. The results were based on a 13-year study of 5,000 men and women.

Type 2 diabetes occurs when the body does not produce enough insulin or becomes less sensitive to its effects. Insulin acts like a key to allow sugar into cells and if, for example, someone is overweight that key works less well.

One theory is that the stress hormone cortisol may also alter the body's sensitivity to insulin.

'Stress leads to a rise in cortisol, a steroid hormone, and sometimes when you give individuals steroids (drugs that resemble cortisol) at a high dose, this impedes the action of insulin,' says Naveed Sattar, professor of medicine at the University of Glasgow.

'So when we do a risk score to see how likely someone is to develop type 2 diabetes, we do ask if they are on steroids, as this can increase their risk.'

While Professor Sattar is not convinced that this means stress itself is a direct cause of diabetes, other experts believe it is.

Professor Andrew Steptoe, a psychologist and epidemiologist from University College London, says his research shows that people with type 2 diabetes react to stress differently - but whether this is what caused their diabetes or is a result of it, is not clear.

In a study of 420 adults, his team found that those with type 2 took longer to recover from a stressful event - their blood pressure and heart rate took longer to return to normal than those without diabetes. The results were published in Proceedings of the National Academy of Sciences.

'Everyone responds to stress with an increase in pulse rate, blood pressure and release of stress hormones,' says Professor Steptoe.

But there was a difference in the length of this response between the healthy participants and those with type 2 - 'Ninety minutes after a stress experience they still hadn't returned to normal levels, unlike the healthy participants'.

Furthermore, Professor Steptoe found that the type 2 diabetics had higher levels of cortisol.

'It might be that they are more exposed to stress, or that they are in a state of high-level activation of the stress response.

Next he plans to follow up healthy people in the study who also showed a prolonged response to stress, to see if they develop type 2.

Professor Steptoe says further research is needed, but adds that we may need to rethink the risk factors for type 2 diabetes and include stress among them.

People with type 2 seem to think there is a strong correlation between stress and the onset of their condition.

A survey of more than 500 patients for the online forum diabetes.co.uk found that 78 per cent believed their condition was brought on by, for example, stress in the workplace, long hours, the breakdown of a marriage or a family bereavement.

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