ENDOCRINOLOGY The Effects of Acute and Chronic Stress on Diabetes Control
ENDOCRINOLOGY The Effects of Acute and Chronic Stress on Diabetes Control
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DOI：
10.1126/scisignal.2003508
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发表时间：
2012-10-23
影响因子：
7.3
通讯作者：
Chiarelli, Francesco
中科院分区：
文献类型：
--
作者：
Marcovecchio, M. Loredana;Chiarelli, Francesco
压力是导致人类病理状况的重要因素。急性和慢性压力情况下发生的荷尔蒙变化会影响健康人和糖尿病患者的葡萄糖稳态。几项研究报告了急性应激对 1 型和 2 型糖尿病患者维持血糖浓度的负面影响。压力对糖尿病患者血糖控制的影响可能与压力激素对血糖水平的直接影响以及压力对与糖尿病治疗和监测以及膳食和运动计划相关的患者行为的间接影响有关。相比之下，没有明确的证据表明生活压力事件会促进儿童或成人患糖尿病。应激性高血糖是急性疾病期间高血糖的发展，代表了应激系统与葡萄糖稳态之间的另一个有趣的联系。大量证据支持应激性高血糖与危重患者发病率和死亡率增加之间的关联。有趣的是，有一些证据支持胰岛素在降低重症监护病房患者的发病率和死亡率方面具有有益作用。最后，压力可以通过促进肥胖和代谢综合征来间接影响 2 型糖尿病的发展。
Stress is an important contributor to pathological conditions in humans. Hormonal changes that occur during acute and chronic stress situations can affect glucose homeostasis in both healthy people and in those with diabetes. Several studies have reported a negative effect of acute stress on maintenance of blood glucose concentrations in patients with type 1 and type 2 diabetes. The effect of stress on glycemic control in people with diabetes may be related to a direct effect of stress hormones on blood glucose levels and an indirect effect of stress on patient behaviors related to diabetes treatment and monitoring and meal and exercise plans. In contrast, there is no clear evidence that stressful life events promote the development of diabetes in children or in adults. Stress hyperglycemia, the development of hyperglycemia during acute illness, represents another interesting connection between the stress system and glucose homeostasis. A large body of evidence supports an association between stress hyperglycemia and increased morbidity and mortality in critically ill patients. Interestingly, there is some evidence supporting a beneficial effect of insulin in reducing morbidity and mortality in patients admitted to intensive care units. Finally, stress can influence the development of type 2 diabetes indirectly by promoting obesity and metabolic syndrome.