Stress creates disharmony in the body's natural environment and thus causes an imbalance in the normal physiological system. The term diabetes describes a group of metabolic disorders, characterized and identified by the presence of hyperglycemia. Essential factors identified to initiate hyperglycemia are excess body weight, high cholesterol, high blood pressure, and lifestyle changes like stress, genetics, etc. Different types of stress and related conditions like depression, anxiety, etc., cause pancreatic β-cell dysfunction and insulin resistance, the prime risk factors in the progression of type 2 diabetes. The neuroendocrine system plays a pivotal role in countering psychological stress is the hypothalamus-pituitary-adrenal (HPA) axis, which secretes glucocorticoids (GCs), e.g., cortisol is the principal stress-responsive natural steroid hormone. The stress system essentially hampers the body's homeostasis and develops serious clinical manifestations. Glucocorticoids exert a strong physiological impact on glucose metabolism directly or indirectly, cause hyperglycemic effect and play an important role in the development of type 2 diabetes observed in patients suffering from chronic stress, Cushing’s syndrome, or patients on long term GCs therapy. This review provides a clear outline on the pathways and mechanisms of stress-linked type 2 diabetes.
Keywords: Type 2 diabetes, stress, glucocorticoids, Hypothalamus-Pituitary-Adrenal (HPA) axis, hyperglycemia, insulin resistance.