The Link Between Type 2 Diabetes and Anxiety Control

A link has been found between type 2 diabetes, inflammation, and emotional stress with roots ingrained in the brain’s ability to control anxiety.

Published in Psychoneuroendocrinology, a recent study found that the control lies in the brain’s executive functions.

A metabolic chain reaction was established that starts with low inhibition and leads to vulnerability of distracting objects, thoughts, information, or activities. Prior research has demonstrated that these vulnerabilities could result in increased anxiety and frequency of anxiety, which is known to activate a metabolic pathway responsible for pro-inflammatory cytokines production.

During the current study, researchers measured the levels of both blood glucose and IL-6, in addition to cognitive tests that measured attention control in more than 800 adults. The results of the study found that patients with low inhibition were more likely to have diabetes compared with high inhibition individuals, because of the pathway from high anxiety to IL-6.

No matter how participants performed on other cognitive tests, the results remained the same. Study authors noted that researchers have believed for several years that there could be a link between anxiety and poor health, including diabetes; however, no research has been performed to detail the biological pathway that is responsible for this association.

“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,” said lead study author Kyle Murdock. “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. The novel part of our study was establishing the pathway from inhibition to anxiety to inflammation to diabetes.”

The data was collected from a Midlife Development in the United States study that included 1255 middle aged adults given cognitive tests 2 years apart. Of the 1255 individuals, 800 had blood tests to check IL-6 and glucose levels.

The findings revealed a positive link between inhibition and diabetes. It was also shown that the pathway went in one direction solely, and that inflammation did not seem to affect inhibition.

“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,” Murdock said. “It's a snowball effect: The further they go, the worse it gets. 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.’”

Authors noted that potential interventions could include stimulant or anti-inflammatory drugs, cognitive behavioral, or mindfulness therapy. Prior research has shown that patients who practice mindfulness are more likely to perform better on inhibition tests, according to the study.

“I'm a firm believer that mindfulness-based approaches to treatment are a great idea, for a lot of reasons,” said researcher Christopher Fagundes. “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.”