Stress and diabetes

Stress is a potential contributor to chronic hyperglycemia and diabetes. Stress has long been shown to have major effects on metabolic activities. When people with Type 2 diabetes are under mental stress, they generally experience an increase in their blood glucose levels. Stress can be a major barrier to effective blood glucose control. If you are experiencing stress or feeling threatened,  your body reacts by elevating your stress hormone levels and thereby causing your nerve cells to fire. Your body releases adrenaline and cortisone into your bloodstream and your respiratory rate increases. The body directs blood to the muscles and limbs allowing you to fight the situation. The body may not be able to process the glucose released by the firing nerve cells if you have diabetes. If this glucose is not converted into the energy it builds up in the bloodstream. This causes your blood glucose levels to rise. 

Diabetes is often a cause of stress, particularly in the early days when you have just been diagnosed. Having to pay close attention to what you eat and having lots of new things to learn and remember can feel tough. Some people with diabetes worry about having hypoglycemia too. Some people may start to feel overwhelmed by their diabetes, feeling frustrated and distressed about having it. 

Stress could also be due to acute or chronic causes. Acute stress is short term and usually the more common form of stress. Acute stress often develops when people consider the pressures of events that have recently occurred or face upcoming challenges in the near future. Whereas, chronic stress develops over a long period of time and is more harmful. Ongoing poverty, dysfunctional family or an unhappy marriage are examples of situations that can cause chronic stress. Chronic stress makes it difficult for the body to return to a normal level of stress hormone activity which can contribute to problems in the cardiovascular and respiratory systems, sleep disorders and immune systems. A constant state of stress can also increase a person’s risk of Type 2 diabetes, hypertension and heart disease. Depression, anxiety and other mental health disorders such as post-traumatic stress disorder can develop when stress becomes chronic. 

It is found that various stress factors can increase a person’s risk of developing diabetes. These include stressful life events or traumatic experiences, general emotional stress, anger and hostility, work stress, distressing sleep etc. Emotional stress can affect a person’s hormone levels potentially destructing how well insulin works. Stress can activate the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. This can cause hormonal changes such as higher cortisol levels and lower levels of sex hormones. The level of these hormones affects insulin levels. Cortisol can stimulate the production of glucose in the body and raise a person’s blood sugar. People with abnormal hormone levels will have an increased waist-hip ratio. This is an important risk factor for diabetes and cardiovascular disease. Chronic stress may also affect the immune system. 

Stress is not a situation or a condition during an adverse reaction, as it is generally assumed. In fact, it is a way by which the body overcomes the demanding or undesirable situation. Whenever we are in some unfavourable conditions, whether it is physical or mental, our body tries to maintain homeostasis and protect itself from such events. Stress is a series of events our body follows to cope with such situations. Stress is simply a response to physical and emotional demands. Stressors can be of many types. Physical or physiological changes in the body, changes in the environment, life events or behaviours etc.  

What are the common symptoms of stress?

Sometimes the symptoms of stress are so subtle and you may not notice them. You may experience headaches, palpitations or fast heart rate, rapid breathing, muscle pain or tension. You may feel irritable, unmotivated, restless, depressed and anxious, you may sleep too much or too little, fatigue, you may remain withdrawn from friends or family, you may drink excess alcohol, use tobacco, you may also eat too much or maybe even too little. 

How does one manage stress?

People may find that certain lifestyle measures can help them manage or prevent stress induced feelings or being overwhelmed. These include doing regular exercises, reducing the intake of alcohol, drugs and caffeine, maintaining a healthy and balanced diet, priority management tasks by organising a day, daily to do list and focusing on urgent or time-sensitive tasks etc. Time management is another important area to be focused on. People should set aside some time to organise their schedules, relax and pursue their own interests. Breathing, relaxation and meditation exercises as in yoga is very helpful. Sharing feelings and concerns with family, friends and colleagues may help in reducing the feeling of isolation. Stress management is important for everyone’s health. But it is particularly vital when you are living with diabetes. That’s because the way your body responds to stress could increase the risk of diabetic complications. 

Steps you need to take to manage stress include educating yourself about diabetes by finding support. Get your medications and meal plan organised well. Meditation and yoga exercises have proven to lower stress. Try progressive muscle relaxation techniques. Be in constant touch with your consultant or health care team. Take a 10-minute walk. Actually, walk helps reduce endorphins in the system that causes stress.