The history of stress hyperglycaemia

Stress hyperglycaemia, is a common phenomenon, frequently associated with adverse outcomes in a number of prevalent conditions including myocardial infarction and stroke. Knowledge on stress hyperglycaemia evolved in tandem with knowledge relating to homeostasis, stress and disease and involved some of the world’s most eminent thinkers. Despite this, it still remains under-recognised.

This paper illustrates significant points in the history of stress hyperglycaemia, from antiquity through to the present day, as well as the challenges faced in translating research into clinical benefit for patients. Profiles of significant protagonists including Claude Bernard, Walter Cannon and Hans Seyle are presented, as well their roles in the emergence of modern-day terminology and pathophysiological models. Major themes such as ‘fight or flight’ and homeostasis are central to this discussion.

Closer to the present day, the role of stress hyperglycaemia in a number of common medical conditions is explored in more detail. Contention around evidence for treatment and the future risk of diabetes mellitus are also discussed.