City doctors find high stress levels linked to diabetes

Could high stress levels, identified as a risk factor for cardiovascular diseases and hypertension, also be associated with metabolic disorders like diabetes? A Delhi based study funded by the Indian Council of Medical Research (ICMR), and carried out by Delhi government’s Guru Teg Bahadur (GTB) Hospital and its associated University College of Medical Sciences (UCMS), has found “significant” clinical evidence to link high stress levels to diabetes, in patients newly diagnosed with Type 2 diabetes, according to doctors.
The study which is currently under publication, found that individuals who had low glucose tolerance levels diagnosed through glucose tolerance tests (GTT) indicating diabetes, had correspondingly high stress levels and low coping levels for stress, on the basis of questionnaires developed to validate stress. Other scientific indicators were used to identify levels of stress in diabetics.

Dr S V Madhu, head of the department of endocrinology and secretary of the Research Society for Study of Diabetes in India, who was the principal investigator, said, “Stress hormone levels, measured as the human body’s hormonal response to stress was also found to be higher in people diagnosed with diabetes. Hormones associated with stress like cortisol and catecholamines were found to be altered or disturbed in people who had low GTT levels.” He added that established chemical changes in the brain, which are associated with stress were also found to be activated in patients with diabetes. “Certain pathways in the brain, like oxidative stress pathways were found to be disturbed in patients with diabetes, indicating stress,” Dr Madhu explained.

The study identified 1,000 people who were put through diagnostics including glucose tolerance and insulin sensitivity tests, and identified 500 as newly detected with diabetes. There stress levels were compared with another 500 who were found to have normal glucose tolerance levels. “To the best of our knowledge, this is the first time that we have been able to establish direct evidence demonstrating that stress plays a clinically significant role in the expression of human diabetes, in India. Again as far as we know, this is the first time that different stress scales have been used to characterise chronic psychological stress to evaluate its role in development of Type 2 diabetes,” Dr Madhu explained.

Now, a five-centre study has been launched by the Research Society for the Study of Diabetes in India (RSSD), an autonomous national body of endocrinologists in Delhi, Bangalore, Mumbai, Puducherry and Hyderabad, to see if scientifically developed modules of yoga, and a monitored dose of fenugreek (methi) seeds can be used in the long term as stress busters to “prevent” diabetes in high-risk individuals. “The significance of association of diabetes with stress is that we identify people at risk, and see if we can actually prevent the onset of the disease, by trying to manage their stress levels,” Dr Madhu explained.

The study, named Indian Prevention of Diabetes Study, is currently recruiting subjects who are at risk for diabetes.

Earlier, Ministry of Health and Family Welfare had launched a programme to identify diabetes in urban slums, to dispel the myth that diabetes was a rich man’s disease. Newsline had reported that Delhi government surveys had found one in 10 slum dwellers screened to be suffering from diabetes, and one in five from hypertension. According to estimates, 12-17 per cent of the population in metropolitan cities in India are affected by diabetes.