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Most people don’t realize that chronic stress is a risk factor and can precipitate the onset of diabetes and interrupt its control. While it is a normal response to danger, it the release of stress related hormones-cortisol, adrenalin, and growth hormone all have the ability to increase blood sugar levels.  Also, psychological factors can have a significant impact on the development and progression of diabetes. Research studies have shown that stress can be an important factor in glucose control and that stress management techniques such as progressive relaxation training can lead to clinically significant improvements in diabetes control.  Other studies have determined that depression is related to diabetes control, particularly in patients with type 1 diabetes. Most recently, Dr. Surwit’s a psychology professor at Duke University is a pioneer in this area of research and author of The Mind-

Body Diabetes Revolution:
The Proven Way to Control Your Blood Sugar by Managing Stress, Depression, Anger and Other Emotions.

Why stress can increase blood sugar in people with diabetes

The perception of stress stimulates the release of the stress hormones that elevates the blood sugar level.  They are needed to help your cells either run or fight (i.e., appropriately respond to the stressful situation) . But they're also released when you experience, non-life endangering less stressful situations that often occur. According to Dr. Surwit, having diabetes means you have a greater chance of being affected by life's stressors.

People with diabetes are more responsive to stress than others. Because of low levels of insulin, their bodies can’t manage the elevated blood sugar levels trigger by the stress response.  Also, stress can cause one to overeat or seek comfort foods, that are often high in sugar, that can also increase blood sugar.

Emotional and physical stress that may occur during an illness or injury can also cause the release of blood sugar that’s been stored in liver and muscle cells.

How Can Stress Be Harmful?

Excessive stress works against diabetes management by:

  • Increasing blood glucose levels (quickly and substantially)
  • Inciting strong negative emotions
  • Impairing sound thinking and decision-making
  • Tempting compulsive, poor eating

Whether or not you have diabetes, over time, stress is harmful because it causes so much wear and tear on the body.

For example, the heart works faster and harder in preparation for physical action. The increase in pulse and blood pressure causes a strain on the heart, veins and arteries.

Prolonged stress also has a negative impact on other bodily systems:

  • Immune
  • Digestive
  • Kidney
  • Reproductive

In addition, the ability to think clearly and to make good decisions is impaired when the mind is burdened with worry, anxiety or fear. This constant mental strain can also increase the risk for depression.

Stress Symptoms

  • Sleeping too much or not enough
  • Changes in appetite (eating more or less)
  • Significant weight loss or gain
  • Frequent bouts of crying
  • Trouble with memory and/or concentration
  • Anxious thoughts (often taking the form of “what if ____________ happens?”
  • Muscle tension (that crick in your neck)
  • Irritability
  • Feeling low or depressed.
  • Being easily angered; being angry a lot of the time.
  • Stomach problems (vomiting, nausea, stomachaches, diarrhea, constipation)
  • Loss of interest in sex
  • Avoidance of work or school tasks and/or difficulty completing them
  • A change in relationships (either avoiding or feeling the need to seek out the company of others more than usual)
  • Headaches
  • Feeling your heart beating (often occurs when trying to fall asleep)
  • Difficulty swallowing or feeling as though you are choking
  • Trembling, shakiness
  • Feeling faint
  • Profuse sweating
  • Teeth grinding
  • Feeling uneasy, on edge

Stress Management for Type 2 Diabetes

Type 2 diabetes requires constant attention, so don't let stress throw you off your game. One of the biggest keys for stress management.

If you have Type 2 Diabetes, it is very important to manage your stress, and not let it interfere with the first step in stress management is to become aware of it.  Most people are on autopilot, when it comes to paying attention to how we feel, and the messages our bodies give us.  A lot of my patients have told me that they are so accustomed to stress and they have a hard time remembering how it feels to be without it.

Pay attention, keep a journal, about your feelings. It’s important to identify your stress triggers and make a conscious effort to address your stress in a healthy way.

Here’s a few helpful stress interrupters:

  •  Reverse negative thinking. Try replacing negative thoughts with positive thoughts, reducing the stress triggers you can, and being good to yourself. "Learn to manage your time well and make yourself a priority," Garcia-Banigan says.
  • Practice Diaphragmatic breathing Research shows as few as 20 deep diaphragmatic breaths interrupts the stress response, and returns your body to a relaxed state
  • Meditate-Various forms of meditation, mindfulness, the Relaxation response, etc., all helps the body to recover from the damaging effects of chronic stress, by creating physiological states that restore and support normal bodily functioning.
  • Journalling-the practice of writing about emotionally challenging issues, whatever they may be promotes relief from long term distress and stimulates health. .
  • Become more optimistic-Optimism helps to improve your health.
  • Get support. Having a chronic condition like type 2 diabetes is stressful in itself. Ask your health care professionals  and caregivers about stress management assistance, and consider joining a diabetes support group.

Source: Superhealing

Surwit, R.S., vanTilbur, M.A.L., Zucker, N., McCaskill, C.M. Parekh, P., Feinglos, M.N., Edwards, C.L., Williams, P., and Lane, J.D. Stress management improves long-term glycemic control in type 2 diabetes. Diabetes Care, 2002, 25, 30-34.

Managing Stress and Diabetes

Handbook of Life Stress, Cognition and Health

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