Comment: High stress level is a silent culprit behind diabetes

SINGAPORE: Whether responding to a professional email or playing the next Candy Crush game, you may want to keep your smartphone at bay until the end of your meal.

Although these dopaminergic results may distract you from the day's misfortunes, these online games can actually induce more stress hormones in your body.

We often think that consuming too much sugar is the main cause of diabetes, but research has shown that lifestyle habits can also induce stress hormones and lead to diabetes.

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Clbadic stress hormones such as cortisol and catecholamines, if they are secreted quite often when our body reacts to stress, can create insulin resistance. And insulin becomes less effective at controlling blood sugar.

THE STRESS THAT LEADS TO DIABETES

Most people view stress as acute stress.

It's at this point that the body goes into the clbadic "fight or flight" mode – like when your heart is racing to prepare you for a great presentation at work or when you're stuck in traffic jams. At this point, your body releases glucose to prepare you to fight or escape.

But chronic stress can also lead to diabetes. For example, when people are struggling with prolonged financial difficulties or have to maintain a difficult relationship, as their alarm system is constantly activated, the pancreas struggles to produce enough insulin to combat the amount of glucose that your body releases.

The human body has a very sensitive stress recognition system because evolution has designed us to respond biologically to stress.

If there are too many interruptions around you – for example when you use your smartphone to watch a video while eating – your stress hormones will increase, more glucose will be produced and if your pancreas can not release enough insulin, you stay up higher. risk of diabetes.

In overtime, your system runs out and becomes less sensitive to insulin. Your blood sugar after a meal will therefore take a lot longer to return to normal when you are stressed.

And when sugars accumulate in your bloodstream, it can trigger a range of health problems. Not only will your weight start to increase. You also start having trouble sleeping. It could also hurt your heart and muscles.

An individual becoming less sensitive to insulin because of stress could be the basis of diabetes development – in addition to following an unhealthy diet.

CURB YOUR STRESS

Deregulation of stress hormones provides an important biological link between stress, depression and type 2 diabetes.

Diabetes is a long-running battle in Singapore, with one-third of Singaporeans likely to contract this chronic disease in their lifetime. The Republic is right behind the United States, where the prevalence of diabetes is the highest in developed countries.

In 2016, the Singapore government declared the "war on diabetes" and implemented strategies ranging from promoting good eating habits to better managing the disease, with the aim of educating its citizens about this deadly disease.

The Ministry of Health has also proposed four measures: first, prohibit the sale of prepackaged drinks with a higher sugar content. Second, impose a tax on manufacturers and importers of these beverages. Third, apply a mandatory nutrition label on the front of the package on these drinks. Fourth, impose wider restrictions or ban advertisements for high-sugar beverages.

But tackling sugar is not enough to solve this pressing problem of the growing prevalence of diabetes.

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Today, one in nine – more than 400,000 people – between the ages of 18 and 69 have diabetes.

We are seeing a dramatic increase in type 2 diabetes among 18- to 40-year-olds, particularly in Singapore. This is no longer just an old illness.

Diabetes will continue to be a problem if nothing is done. The number of people under the age of 70 is expected to increase to 670,000 by 2030 and one million by 2050.

NOT ONLY SUGAR

We need to re-evaluate how we treat diabetic patients in Singapore, especially younger patients, instead of seeing this as a war against sugar.

Studies conducted in recent years have shown that diabetes is not just a glucose-related disease, but a multifaceted disease that can be caused by factors other than the consumption of sugary drinks or treats.

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A healthy diet, with less sugar, can help, but prevention strategies should also take into account other factors making diabetes more likely.

We must not simply reduce the level of glucose in the blood; we also need to address blood lipids, cholesterol and blood pressure, which means we need to help people be active in reducing their body mbad index and improving weight loss.

We must also help diabetics manage hypercholesterolemia – to reduce their consumption of tobacco and alcohol.

And we also need to help people participate in prevention activities – with proper eye and kidney checks to detect warning signs

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We need to better manage chronic disease as individuals. Even if it is possible to manage it, for example through insulin injections, not tackling its root causes will result in constant deterioration and devastating complications such as insufficient kidney, nerve damage and heart disease.

S tackle diabetes on many fronts

Diabetes is a chronic disease that requires a comprehensive and sustained set of treatment strategies. As with any chronic or noncommunicable disease, self-management is a key component of successful treatment and improved health outcomes.

Understanding the information and having the ability to translate this information into positive personal care behaviors are the main components of diabetes education.

Well-informed diabetic patients and their families can in turn play the role of ambbadadors and support a wide range of activities promoting healthy living within the community.

Managing our stress level can be a good first step in the fight against diabetes.

Professor Bernhard Boehm is the Ong Tiong Tat Chair in Diabetes Research, Professor of Metabolic Medicine and Scientific Director of the Metabolic Disorders Research Program at NTU Lee Kong Chian School of Medicine.