Stress, when not managed properly, can cause all sorts of sickness. We want to investigate whether stress can also cause diabetes.

There are two major types of diabetes: type 1 diabetes mellitus and type 2 diabetes mellitus.

Type 1 diabetes mellitus is also known as juvenile diabetes because it starts in children and young adults. It is due to insufficient amount of insulin being produced (known as insulin deficiency). Since it does not start later in life, we can safely conclude that type 1 diabetes mellitus is unlikely to be caused by stress.

Type 2 diabetes mellitus usually occurs later in life, after the age of forty. Type 2 diabetes mellitus is the most common form of diabetes. In type 2 diabetes mellitus, the problems arise because

1. Either the body does not produce enough insulin, or
2. The insulin produced is ignored by the cells in the body (known as insulin resistance), or both.

Discussion on what insulin is and what the roles it plays is in order.

Insulin is a hormone that regulates carbohydrate metabolism (and to some extent fat metabolism as well). Insulin helps the body to use sugar. Sugar is the basic source of energy for the cells in the body, and insulin takes the sugar from the blood into the cells.

When we say blood sugar, we refer to glucose in the blood because glucose is the main type of simple sugar in our blood. Our body needs to have glucose level controlled to within a narrow range (0.7-1.1 mg per ml). Below 0.7 mg per ml is termed "hypoglycemia", and above 1.8 mg per ml is termed "hyperglycemia". Both can result in problems as we shall see later.

When there is more glucose in the blood, more insulin is secreted into the blood, resulting in cells (muscle cells, red blood cells and fat cells) absorbing the glucose out of the blood, thus reducing the blood glucose level.

When there is less glucose in the blood, more glucagon (counter part of insulin) is secreted into the blood, stimulating liver to release the glucose it has stored in its cells into the blood stream, thus increasing blood glucose. Glucagon also induces the liver and some of the muscle cells to produce glucose out of protein.

If the glucose does not go into cells, instead it builds up in the blood, two problems arise. Firstly, if the cells do not get the glucose they need, they die. Secondly, prolong period of high blood glucose levels may hurt your eyes, kidneys, nerves or heart. Insulin is used to treat this "hyperglycemia" aspect of diabetes.

"Hypoglycemia" or low blood glucose level condition can happen when more insulin is introduced than there is food in the stomach to be acted on. This often happens when a patient injects insulin in anticipation of food consumption, but the food consumption is delayed or insufficient food is consumed. Symptoms of "hypoglycemia" include strange behavior, clumsy or jerky movements, seizure, confusion, tingling sensations around the mouth, dizziness, sweating, headache etc.

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