13/08/2025
*Bi Directional Relation of Diabetes Obesity and Mental Health*
Main Components:
1) Metabolic > Psychiatric Axis:
Chronic Inflammation: Adipose tissue, not just a storage organ; it is an active endocrine organ that releases pro-inflammatory cytokines like IL-1, IL-6, TNF-alpha, CRP etc.
* Effect: These inflammatory markers travel through the bloodstream and can cross the blood-brain barrier.
Outcome: These lead to neuroinflammation > chronic inflammatio of brain > disrupts neurotransmitter systems (e.g., serotonin, GABA), impairs the growth of new brain cells (neurogenesis), and is a significant contributor to the development of depressive symptoms.
2) Psychiatric > Metabolic Axis:
Dysfunction in Brain:
a) *HPA Axis* dysfunction:
Psychological disorders causes hyper stimulation of HPA Axis > hypothalamus (CRH) and pituitary gland (ACTH) stimulate the adrenal gland to release excess Cortisol leading to
*Insulin resistance
*Mitochondrial dysfunction
b) Dysfunction of *Gut-Brain Axis*: Vagus nerve - Direct neuroanatomical connection,
* Dysfunction of transmitting signals of gut products and metabolites
* Uncontrolled hunger & satiety signalling > Weight gain > Production of inflammatory cytokines > Insulin resistance > Diabetes.
c) Dysfunction of production & function of Gut Biochemicals like:
* Dysfunction of Immune Modulators: Immune cells > anti-inflammatory cytokines, it's dysfunction causes systemic and brain inflammation.
* Dysfunction of Bacterial Metabolites: Dysbiosis of Gut microbiota > SCFAs, which can influence brain function and microglial activation is altered.
* Dysfunction of Neurotransmitters: Serotonin and GABA, which can affect mood, cognition, and overall brain health is altered.
d) Anti-Psychotic Medications - Weight gain > Production of inflammatory cytokines > Insulin resistance > Diabetes.
Key note: Each and every Diabetic or Obese patient should be screened for any Mental distress and manage with care, concern and empathy.
