Abstract
The influence of psychological variables upon diabetes was documented as early
as the 17th century. The great British physician, Thomas Willis (1679), noted
that diabetes often first appeared in patients who had experienced a significant
life stress. Two hundred years later, the work of Claude Bernard (1849, 1856,
1857) provided a theoretical rationale for the effects of stress on diabetes (see
Unger, 1979). Bernard, who is often considered to be the father of modern
physiology, observed that diabetes could be produced in a normal animal by
lesioning the area of the hypothalamus. He also showed that the liver could both
store sugar in the form of glycogen and release it when needed. He postulated
that the brain was the control center for these anabolic and catabolic events and
consequently, that diabetes resulted from a disorder of the central nervous system
in which there was a disturbance of homeostasis (see Fig. 5.1). Because Bernard
saw the brain as the control center of metabolic function, his model provided a
physiological mechanism explaining the observed relationship between psychological stress and diabetes mellitus. By the end of the century, the importance of
anxiety and stress in the etiology and course of some cases of diabetes was noted
in the major medical and psychiatric texts of the time (e.g., Osler, 1892,
Maudsley, 1899).