Effect of Chronic Stress on Insulin Resistance and Hba1c Levels: Literature Review

I Gusti Ngurah Krishna Priyaka^*, Dian Pritasari Jeger, Made Edwin Sridana

Abstract

Chronic psychological stress has been increasingly recognized as a major factor influencing glycemic control in diabetes mellitus, particularly type 2 diabetes (T2DM). This literature review explores the physiological and behavioral mechanisms linking chronic emotional stress with insulin resistance and elevated HbA1c levels. Activation of the hypothalamic–pituitary–adrenal (HPA) axis and sympathetic nervous system during prolonged stress leads to increased secretion of cortisol and catecholamines, promoting hepatic gluconeogenesis, lipolysis, and insulin resistance. Concurrently, chronic stress triggers inflammatory cytokines such as IL-6, which further disrupt insulin signaling pathways. Behavioral consequences, including poor medication adherence, unhealthy dietary habits, reduced physical activity, and sleep disturbances, exacerbate glycemic dysregulation. Evidence from observational and interventional studies consistently demonstrates that higher psychological distress correlates with poor glycemic control, while psychological interventions such as Cognitive Behavioral Therapy (CBT), Mindfulness-Based Stress Reduction (MBSR), and resilience training can improve HbA1c and overall well-being. The integration of stress screening and management into diabetes care, as recommended by major international guidelines, may optimize metabolic outcomes and enhance quality of life for patients. This review underscores the necessity of a holistic biopsychosocial approach in diabetes management.

Keywords

chronic stress; insulin resistance; HbA1c; diabetes mellitus;  HPA axis; psychological intervention; glycemic control

Cite This Article

Priyaka, I. G. N. K., Jeger, D. P., Sridana, M. E. (2026). Effect of Chronic Stress on Insulin Resistance and Hba1c Levels: Literature Review. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 1: Jan – Feb 2026, Pages 95-99 URL: https://www.ijscia.com/wp-content/uploads/2026/01/Volume7-Issue1-Jan-Feb-No.1021-95-99.pdf

Volume 7 | Issue 1: Jan – Feb 2026