Epidemiology and Population Health
Understanding the complexity of
glycaemic health: systematic bio-psychosocial modelling of fasting glucose in middle-age
adults; a DynaHEALTH study
- Estelle Lowry,
- Nina Rautio,
- Ville Karhunen,
- Jouko Miettunen,
- Leena Ala-Mursula,
- Juha Auvinen,
- Sirkka Keinänen-Kiukaanniemi,
- Katri Puukka,
- Inga Prokopenko,
- Karl-Heinz Herzig,
- Alexandra Lewin,
- Sylvain Sebert &
- Marjo-Riitta Järvelin
International Journal of Obesity (2018)
Working with Indigenous peoples of various
parts of the world, I was made well aware of the social aspects of their
disease burden.
At a gathering of elders of a particular
tribe I asked the question:
Can STESS cause Diabetes among the Indians?
The answer from them was a resounding YES.
When I used to mention the possibility that
Diabetes may be a Social Disease, the looks of my colleagues bordered on the
contemptuous, mired as they were in Pancreatic Exhaustion, Genes for Obesity,
Metabolic Syndrome among other biomedical concerns. The word Socioeconomic
factors and Lifestyle were thrown around, but without any understanding nor
explanation.
For me, a qualitative explanation of socioeconomic
factors (poverty and education) and Lifestyle (the results thereof) could be
captured in Quality of Life. But I was more interested in the social aspects,
which may enhance the effects of a poor Quality of Life.
The psychosocial aspects include:
Employment status
Marital status (I would include Sexual
Health as well)
Home Ownership
Depression
Sleep Quality
Life Satisfaction
Adaptive coping.
These factors are relevant to people living
in the richer countries. As the prevalence of Diabetes is increasing in the
poorer countries, we may have to include other factors in the Socio Economic
aspects that cause Diabetes.
The authors of the article have this to
say, in their conclusion:
We speculate that the psychosocial factor may
actually be capturing a ‘stress’ effect. Strong
biological links exist between glucose metabolism and neuroendocrine responses
to variation in psychosocial well-being. The hormonal outputs of the
hypothalamic-pituitary-adrenal axis, such as the glucocorticoids, acutely alter
short-term glucose metabolism . Long-term exposure to psychosocial stressors
may contribute to chronic glycaemic dysregulation in individuals. The independent effects of the
psychosocial and metabolic factors suggest that there are separate biological
pathways in which fasting glucose levels are maintained
As
Microbiome, Inflammation and Oxidative Stress have encountered the discourse
and their relationship with psychosocial factors are being investigated, newer pathways,
which differ from biological ones, would become evident in the near future.
Exciting indeed!
For those who are philosophically inclined, I attach a video by the Indian Mystic SADHGURU
on Arrogance and its ill effects on the body!
