Dysglycemia-Based Chronic Disease and Lifestyle Medicine: Mechanistic Interpretation Using the Allostatic Load Model

Abstract

Dysglycemia-based chronic disease (DBCD) comprises insulin resistance, prediabetes, and type 2 diabetes, and their staged progression, complications, and impact contribute to one of the largest public health burdens worldwide. The clinical and economic effects of DBCD are fueled by external stressors related to modern society and lifestyles, especially in low socioeconomic strata. Chronic stressor exposure leads to chronic stress, characterized by immune-neuroendocrine activation and mobilization/depletion of metabolic resources. This complex adaptive response engaging many different signaling pathways is termed allostasis and principally regulates homeostatic mechanisms. Allostatic load is the metabolic cost of adaptation to environmental factors and can lead to numerous adverse health outcomes and behaviors. In this narrative review, the bidirectional relationship between allostatic load and unhealthy behaviors is analyzed in the context of DBCD development and progression, with a focus to reduce individual vulnerabilities.