The present study investigated the possible involvement of stress in the aetiopathogenesis of type 2 diabetes mellitus by using three different approaches: the role of chronic and subacute stress, assessed by a clinical interview in 300 newly discovered diabetic patients; the role of acute stress, by analysing the incidence of diabetes mellitus in connection with the earthquake of 4 March 1977; and investigating the autonomic reactivity of patients in whom stress was or was not involved in the onset of diabetes. The results showed: a chronic psychosocial stress was encountered in 44 per cent of 300 newly discovered type 2 diabetes mellitus patients; the number of newly registered diabetic cases was significantly (p < 0.001) higher in the month of May in 1977 (two months after the earthquake) as against the years preceding (1976) or following (1978) the earthquake; an autonomic hyperreactivity was found in the patients in whom stress was involved in the onset of diabetes as against the controls or diabetics in whom this factor was not involved in the onset of the disease.
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