title: Aetiopathogenesis of type-2 diabetes mellitus: could chronic stress play an important role?
abstract: OBJECTIVE
  Pathogenesis of type-2 diabetes remains elusive. Various factors including diet, physical exercise, obesity, genetic factors and stress, have been discussed. Among these factors role of stress is still poorly understood in diabetes. Therefore the study was planned to assess effect of stress in diabetic and non-diabetic population in a comparative descriptive manner.
  
  
  METHODS
  1000 diabetic cases (group A) and equal number of healthy individuals were selected as a comparison group (group B). Both groups were examined at 0, 12, 24 months. To assess stress 17 points were examined (factors mainly related to emotions, hurriedness, relaxed status etc.), total 68 points for stress were given; > 30/68 was considered as severe stress. Mental health life style factors like duration of sleep and working mental hours were also examined. EEG and SSR were done at 24 months to assess stress and sympathetic response.
  
  
  RESULTS
  There was presence of chronic stress, (> 90% had > 30/68 scoring) more mental work and less sleep duration in group A. EEG showed synchronised v/s desynchronised basal rhythm in group B v/s group A. SSR suggestive of increased sympathetic activity in group A.
  
  
  CONCLUSIONS
  It is concluded that chronic stress leads to increased basal sympathetic activity, resulting from disturbed cortical hypothalamic axis, leading to central insulin resistance and diabetes.
authors: Tarun Kumar
authors: TK
authors: Saxena
authors: Sanjiv
authors: S
authors: Maheshwari
authors: Manjari
authors: M
authors: Saxena
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D013315:Stress, Psychological / Q000150:complications*