Researchers Detail Link Between Stress and Diabetes

Summary: Researchers report they have established a link between emotional stress and diabetes.

Source: Rice University.

Connection established between anxiety control, inflammation and Type 2 diabetes.

A Rice University study has found a link between emotional stress and diabetes, with roots in the brain’s ability to control anxiety.

That control lies with the brain’s executive functions, processes that handle attention, inhibition, working memory and cognitive flexibility and are also involved in reasoning, problem-solving and planning.

The study published in Psychoneuroendocrinology establishes a metabolic chain reaction that starts with low inhibition, aka attention control, which leaves a person vulnerable to tempting or distracting information, objects, thoughts or activities. Previous studies have shown that such vulnerability can lead to more frequent anxiety, and anxiety is known to activate a metabolic pathway responsible for the production of pro-inflammatory cytokines, signaling proteins that include interleukin-6 (IL-6).

Flow chart extablishes the link between stress and diabetes.
Rice University researchers have established a metabolic connection between the brain’s executive function responsible for inhibition and type 2 diabetes. image is credited to Andrea Lugo/Rice University.

Along with cognitive tests that measured attention control, the Rice study measured levels of both blood glucose and IL-6 in more than 800 adults. IL-6 is a protein the body produces to stimulate immune response and healing. It is a biomarker of acute and chronic stress that also has been associated with a greater likelihood of diabetes and high blood glucose.

The research showed individuals with low inhibition were more likely to have diabetes than those with high inhibition due to the pathway from high anxiety to IL-6. The results were the same no matter how subjects performed on other cognitive tests, like those for memory and problem-solving.

Researchers have suspected a link between anxiety and poor health, including diabetes, for many years but none have detailed the biological pathway responsible, said lead author Kyle Murdock, a postdoctoral research fellow in psychology. He said the Rice study takes a deeper look at how inflammation bridges the two.

“The literature shows individuals with poor inhibition are more likely to experience stressful thoughts and have a harder time breaking their attention away from them,” Murdock said. “That made me wonder if there’s a stress-induced pathway that could link inhibition with inflammation and the diseases we’re interested in, such as diabetes.

“Plenty of research shows that when individuals are stressed or anxious or depressed, inflammation goes up,” he said. “The novel part of our study was establishing the pathway from inhibition to anxiety to inflammation to diabetes.”

Murdock works in the Rice lab of Christopher Fagundes, assistant professor of psychology. The Fagundes lab investigates processes that happen along the border of psychology and physiology, and how those processes affect overall health and potential treatments.

The data came from a Midlife Development in the United States study of 1,255 middle-aged adults whose cognitive abilities were tested two years apart. More than 800 of those also underwent blood tests to check IL-6 and glucose levels. The Rice researchers found not only the positive link between inhibition and diabetes, but the absence of a link between other cognitive functions and the disease. They also determined that the pathway only went in one direction: Inflammation never appeared to affect inhibition. Murdock said a year as a clinical psychology intern at the Oregon Health and Science University, where he studied with co-author and psychologist Danny Duke, led the researchers to think there could also be a feedback loop at play in those with diabetes. “Individuals who are anxious are more likely to avoid treatment and use maladaptive strategies (like smoking or unhealthy diets) that enhance their blood glucose, which is problematic. It’s a snowball effect: The further they go, the worse it gets,” he said.

“We also know that extremely high blood glucose can impact cognition as well. We talked about how, if we’re going to treat these individuals appropriately, it won’t be by sitting them down in a room and saying, ‘Hey, you need to eat better,’ or ‘You need to use your insulin on time.'”

The researchers listed several possible interventions, including mindfulness therapy, stimulant or anti-inflammatory medications and cognitive behavioral therapy. “Research shows that people who practice mindfulness do better on the inhibition tests over time,” Murdock said, suggesting that shifting one’s attention away from stressful thoughts may affect physiological responses.

“I’m a firm believer that mindfulness-based approaches to treatment are a great idea, for a lot of reasons,” Fagundes said. “That doesn’t mean medicines that promote inhibition, such as stimulants, shouldn’t be considered, but a combination of the two could be really helpful.”

About this psychology research article

Co-authors of the paper are Angie LeRoy, a Rice staff member and a graduate student at the University of Houston; and Tamara Lacourt, a postdoctoral researcher, and Cobi Heijnen, a professor of symptom research at the University of Texas MD Anderson Cancer Center.

Funding: The National Institute on Aging and the National Heart, Lung and Blood Institute supported the research.

Source: Jeff Falk – Rice University
Image Source: This image is credited to Andrea Lugo/Rice University.
Original Research Abstract “Executive functioning and diabetes: The role of anxious arousal and inflammation” by Kyle W. Murdock, Angie S. LeRoy, Tamara E. Lacourt, Danny C. Duke, Cobi J. Heijnen, and Christopher P. Fagundes in Psychoneuroendocrinology. Published online May 18 2016 doi:10.1016/j.psyneuen.2016.05.006

Cite This Article

[cbtabs][cbtab title=”MLA”]Rice University. “Researchers Detail Link Between Stress and Diabetes.” NeuroscienceNews. NeuroscienceNews, 6 June 2016.
<>.[/cbtab][cbtab title=”APA”]Rice University. (2016, June 6). Researchers Detail Link Between Stress and Diabetes. NeuroscienceNews. Retrieved June 6, 2016 from[/cbtab][cbtab title=”Chicago”]Rice University. “Researchers Detail Link Between Stress and Diabetes.” (accessed June 6, 2016).[/cbtab][/cbtabs]


Executive functioning and diabetes: The role of anxious arousal and inflammation

Individuals who perform poorly on measures of the executive function of inhibition have higher anxious arousal in comparison to those with better performance. High anxious arousal is associated with a pro-inflammatory response. Chronically high anxious arousal and inflammation increase one’s risk of developing type 2 diabetes. We sought to evaluate anxious arousal and inflammation as underlying mechanisms linking inhibition with diabetes incidence. Participants (N = 835) completed measures of cognitive abilities, a self-report measure of anxious arousal, and donated blood to assess interleukin-6 (IL-6) and glycated hemoglobin (HbA1c). Individuals with low inhibition were more likely to have diabetes than those with high inhibition due to the serial pathway from high anxious arousal to IL-6. Findings remained when entering other indicators of cognitive abilities as covariates, suggesting that inhibition is a unique cognitive ability associated with diabetes incidence. On the basis of our results, we propose several avenues to explore for improved prevention and treatment efforts for type 2 diabetes.

“Executive functioning and diabetes: The role of anxious arousal and inflammation” by Kyle W. Murdock, Angie S. LeRoy, Tamara E. Lacourt, Danny C. Duke, Cobi J. Heijnen, and Christopher P. Fagundes in Psychoneuroendocrinology. Published online May 18 2016 doi:10.1016/j.psyneuen.2016.05.006

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  1. I don’t know 2005 car accident severe whiplash, concussion. Severe thoriatic pain also by 2006, caught Mrsa working in hospital, severe anxiety worse than I ever had medications could not control it, I had been diagnosed previously with Gad and agoraphobia from 17 on, but was controlled with anti anxiety and anti depression Meds, PTSD 2007 then Both feet operated on for high arch nerve pain though out spine. Possible CMT…Diagnosed again myfasiol pain, fibromyalgia, low vitamin D, fast forward 2011? Diagnosed anterior pituitary disorder, migraines, cyst on pineal gland. Cervical spine central stenious multi level-2006, birth defects – thoriatic vertebrae fused on one level, calfs deformed, along with high arch
    Lumber Mri’s showed focal points possible early anklosing spondylitis, chronic pain almost gone except back, blood work shows metabolic changes, watch for diabetes 2, EBV previous? Very high Ebna-IGG and Vca-IGG , chronic constipation, and brain memory, comprehension decline with anxiety persistent.
    I wouldn’t know which area of Neuroscience to start lookingfor a diagnosis …..maternal history for clumsiness disorders, ADHD, learning disabilities, dyslexia, faces non recognition-me, foot disorders, scoliosis hunch on both sides, cleft lip brother, meningitis other brother along with Von willebrants deasease son also has Von willebrants desease, I Have anemia, Previous surgery pre cancer cervical, High arches, MRSA surgery, I have Strong history of viral and bacterial infections, the list goes on, that’s most of it, that’s why I don’t get help because I’d have no clue where to start? Stimulants help but wear off, sleep disorder i, 2 week monitor and records. I woke up all though night without knowing one night was over 200 times, if I didn’t have the recording to hear myself mumbling. Coughing, I wouldn’t believe it myself. So is it all related to initial
    Is it TBI, Whiplash, PTSD, severe ongoing sleep disorder, anxiety? What about anxiety before accident?
    Too confusing my mind shuts off, and I freeze on any pro health or doctor because I don’t know where to start?I just wish I was half the person I used to be.. Rita

  2. With my husband I can see a strong candidate for being off medication with proper other medications. He told me one time that stimulates helped him. However he presents with a fear response on occasion out of nowhere and with no reason. I have noticed when vacation(free time) and his love seem to control him he gets home as his comfort. He knows he is protected from all at home I am seeing improvement especially after this get away in the mountains. He had to do nothing but be sure. It seem to work. Of course he does not understand this but it is important right now that he really didn’t need anything further but me and him. He is anxious traveling I suspect because of his bad wreck and bad treatment that left his arm without full extension. The doctor didn’t like motorcycles. A man intoxicated had run a stop sign on purpose and it tore half his face off and broke his arm when his body hit the truck. This I believe is a cause of him not talking alot about it because he seemed to have extraordinary strength and resilience. He didn’t want to worry his mom. Him and his brother rough housed growing up. His brother excels with no issues besides the Vietnam era but my husband needs assurance it’s ok to be himself.

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