Diabetes mellitus (DM) is a serious medical and social problem, which is due to its high prevalence, the continuing tendency to increase the number of patients, the chronic course that determines the cumulative nature of the disease, and the high disability of patients. In quantitative terms, type 2 diabetes accounts for 85-90% of the total number of patients suffering from this disease.
To date, a large amount of information has accumulated indicating that the nervous and endocrine systems are components of the overall adaptation system. The question of the role of emotional influences in the etiology and pathogenesis of DM has become relevant with the development of psychosomatic medicine.
When any emotional stressor affects the body, a non-specific reaction is activated in the form of a General adaptation syndrome, which in the case of a latent course leads to the manifestation of DM, and in the case of a genetic predisposition, it causes the disease.
Stressors indirectly, through the senses, activate the hypothalamic-pituitary-adrenal system, resulting in a number of effects on the main pathogenetic links in the development of diabetes (insulin resistance and secretory defect of the beta cell). Emotional States are usually accompanied by hyperglycemia due to increased glycogenolysis and gluconeogenesis. Hyperinsulinemia that occurs in response during a long course leads to both insulin resistance, due to a decrease in the sensitivity of peripheral receptors to insulin and a decrease in their number, and to depletion of beta-cell reserves. In view of the reduction of compensation, chronic hyperglycemia acting on the beta cell leads to a decrease in insulin secretion, and the “glucose-toxic effect” leads to its apoptosis.
Chronic emotional experiences cause the occurrence of chronic visceral-vegetative disorders, which means the possibility of autonomization of somatic disorders.
The aim of our study was to investigate the role of emotional stress in the development of type 2 diabetes.
We examined 41 patients undergoing inpatient treatment in the endocrinology Department with a diagnosis of type 2 diabetes. The average age was 43.33±1.33 years, the duration of DM from the moment of diagnosis was 9.62±0.73, 19 (46%) had a hereditary burden, and 31 (76%) had diabetes associated with the effect of psychotraumatic factors.
The majority of the surveyed (88%) had secondary and specialized secondary education, only 15 (42%) of them had a hereditary predisposition to diabetes. At the same time, patients with higher education out of 5 people-4 (80%) had first-line relatives suffering from diabetes, which may indicate a better development of coping mechanisms in overcoming adverse external influences and a greater importance of their hereditary predisposition.
Patients with hereditary burden had an earlier onset of the disease, and the peak occurred at the age of 35 to 40 years, while patients without hereditary burden were significantly more likely to develop diabetes from 40 to 45 years (p<0.05).
Interesting in our opinion is the fact that out of 22 patients who do not have hereditary burden, 19 (85%) diabetes mellitus was provoked by emotional stress, on the contrary, out of 19 patients who have relatives with diabetes, only 12 (63%) indicated a link between the development of the disease and the action of psychoemotional factors. Analyzing the intensity of emotional stress, it can be noted that acute and chronic stress preceded the development of diabetes with equal frequency.
Among the areas of strong emotional experiences, 24 people (77%) identified family and household issues, highlighting the causes of illness and death of loved ones, divorce, and long-term family conflicts. Workplace stress was observed in 4 people (1%), the reasons were dismissals, conflicts at work. In 3, the onset of dia beta was triggered by treatment for other diseases with glucocorticoid drugs, which in our opinion confirms the role of these hormones in provoking the onset of diabetes.
Thus, we can draw the following conclusions: emotional stress plays an important role in the occurrence of type 2 diabetes in patients with secondary and specialized secondary education. The age of onset of the disease is more affected by hereditary predisposition, acute and chronic stress precede the development of diabetes to an equal extent. Emotional influences play a significant role in the occurrence of the disease in patients without a hereditary predisposition and only provoke it in patients with it. Most stress is associated with the family and household sphere, which is associated with its emotional significance for a person.