Shared Dysregulation of Homeostatic Brain-Body Pathways in Depression and Type 2 Diabetes
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Purpose of Review
The purpose of this review is to provide an overview of shared dysregulation of the hypothalamic-pituitary-adrenal (HPA) and brain-gut-microbiome (BGM) axes associated with depression and type 2 diabetes (T2D). Clinical implications and future research are also discussed.
Both depression and T2D are associated with dysregulation of the HPA and BGM axes. These pathways regulate immune function, glucose metabolism, and sleep, which are altered in both illnesses. Dysregulation of homeostatic brain-body pathways may be positively influenced through different therapeutic actions, including psychotherapy, healthy eating, physical activity, sleep promotion, and certain anti-inflammatory or antidepressant medications.
While the causal nature of the relationship between depression and T2D remains unclear, these conditions share dysregulation of homeostatic brain-body pathways that are central to mental and physical health. Better understanding of this dysregulation may provide opportunities for interventions that could benefit both conditions. Future research should examine the additive burden of depression and T2D on HPA and BGM dysregulation and better differentiate depression from emotional distress.
KeywordsType 2 diabetes Depression Biological pathways Hypothalamic-pituitary-adrenal axis Brain-gut-microbiome axis
Dr. Gonzalez's effort is partialy supported by grants from the National Institutes of Health: R18 DK098742, R01 DK104845 and P30 DK111022. Support was also provided by The Drs. David and Jane Willner Bloomgarden Family Fellowship Fund.
Compliance with Ethical Standards
Conflict of Interest
Claire J. Hoogendoorn, Juan F. Roy, and Jeffrey S. Gonzalez declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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