Figure 2: Schematic representation of physiological and molecular mechanisms responsible for hyperactivity of HPA axis observed in type 1 diabetes.
Diabetes induces increase in AVP, ACTH and MC2R levels and decrease of glucocorticoid negative feedback. The impaired of negative feedback in diabetics is related with reduction of GR and MR expression in pituitary. Together, these alterations in HPA axis lead to increase of glucocorticoid levels culminating in the development and/or aggravation of diabetic complications.