Dysregulated responses to stress and weight in people with type 2 diabetes

• Published in: Journal of psychosomatic research Vol. 170; p. 111354
• Main Authors: Hackett, Ruth A., Gareddu, Alessia, Panagi, Laura, Steptoe, Andrew, Poole, Lydia
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.07.2023; Pergamon Press
• Subjects: Blood Pressure; Body Mass Index; Cardiovascular System; Diabetes Mellitus, Type 2 - complications; Humans; Hydrocortisone; Laboratory stress testing; Obesity; Short Communication; Type 2 diabetes; Weight Gain; Type 2 diabetes; Obesity; Laboratory stress testing
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2023.111354

Dysregulated stress responsivity has been linked with weight gain in healthy samples. However, the relationship between disturbances in stress-related biology and changes in weight in people with type 2 diabetes (T2D) is unclear. A total of 66 participants with T2D underwent laboratory stress-testing in 2011–2012. Cardiovascular, neuroendocrine and inflammatory responses to standardised mental stress were assessed, and Body Mass Index (BMI) was measured. Participants self-reported information on BMI in 2019. Associations between stress-related biological responses and BMI at follow-up were modelled using linear regression adjusting for age, sex, resting biological levels and baseline BMI. Blunted diastolic blood pressure reactivity (B = −0.092, 95% CI -0.177; −0.007, p = 0.034) as well as poorer systolic blood pressure (B = −0.050, 95% CI -0.084; − 0.017, p = 0.004), diastolic blood pressure (B = −0.068, 95% CI -0.132; −0.004, p = 0.034) and heart rate (B = -0.122, 95% CI -0.015;-0.230, p = 0.027) recovery post-stress were associated with higher BMI 7.5 years later. Greater interleukin-1 receptor antagonist (B = 16.93, 95% CI 6.20; 27.67, p = 0.003) and monocyte chemoattractant protein-1 reactivity (B = 0.04, 95% CI 0.002; 0.084, p = 0.041) were associated with weight gain. No significant associations were detected for interleukin-6 or laboratory cortisol measures. Disturbances in stress-related biology may promote weight gain in people with T2D. Research with a larger sample size is required to explore associations between stress responsivity and BMI in people with T2D. •Obesity is common in diabetes and increases the risk of diabetes-complications.•We assessed stress responses and later body mass index (BMI) in diabetes.•Blunted cardiovascular reactivity and poor heart rate recovery are linked with weight gain.•Greater inflammatory responses are linked with higher BMI 7.5 years later.•Disturbed stress-related biology may promote weight gain in diabetes.