Sarah A. Stanley, MBBCh, PhD, Icahn School of Medicine at Mount Sinai
Published in Nature, September 2025

Previous research suggests that people with above-average activity in the amygdala—the emotional center of the brain—have a much higher risk of developing diabetes. In her earlier career as a clinician, Dr. Stanley also observed that stressful situations, from a routine doctor’s visit to a medical emergency, caused patients’ blood glucose (blood sugar) to spike, even if their diabetes was otherwise well managed. Because of the connection between the amygdala and diabetes, this raised the question as to whether there is a connection between emotional stress and blood glucose spikes.

With the ADA’s Pathway grant, Dr. Stanley and her team set out to unravel the many ways the central nervous system regulates how the body breaks down, stores, and uses blood glucose. Using mice, she traced a new connection between the amygdala and other organs that signal the liver to rapidly release extra blood glucose in response to stressful stimuli. 

“Clinicians give a lot of advice about lifestyle factors such as healthy eating and exercise. We should pay as much attention to managing chronic stress,” said Dr. Stanley

What's more, Dr. Stanley’s team discovered that when stress happens again and again, this pathway starts to wear out and stops working properly. As a result, the liver begins sending out too much glucose even when it isn't needed. When this chronic stress is combined with a high-fat diet, the body’s metabolism becomes overloaded, leading to ongoing high blood glucose and gradual weight gain.

This research underscores the importance of addressing acute and chronic stress, both to stave off complications for people living with diabetes and to prevent type 2 diabetes. She hopes these and subsequent findings could lead to new targeted therapies to improve blood glucose management for people at high risk. 

Dr. Stanley credits the Pathway program—both the funding and the mentorship from other experts in the diabetes field—with making her team’s work possible. “It was transformative because it allowed me to explore a new area,” she said. “Right now is a really important time for science. Showing support for basic and clinical research has a huge impact because you just don’t know where it’s going to lead. It could be the next big thing in diabetes treatment, and we won’t know unless we support it.”