How are diabetes and stress linked?
For example, a person may feel that their stress levels rise when having to plan meals and measure their blood sugar, especially in the early stages of a diabetes diagnosis. However, stress can also increase a person's blood sugar and glycated hemoglobin levels.
Research has also linked high levels of lifetime stress to an increased risk of developing type 2 diabetes.
In this article, we discuss how stress affects blood sugar. We also look at what the research says about the best ways people with diabetes can reduce stress.
How does stress affect diabetes and blood sugar?
Research suggests that a person has a higher risk of developing type 2 diabetes if they experience depression or anxiety.
Researchers have been discussing the potential link between diabetes and stress since the 17th century.
A review article from 2010 reports that people who experience depression, anxiety, stress, or a combination of these conditions are at higher risk of developing diabetes.
The scientists found that various stressors can increase a person's risk of developing diabetes, including:
- stressful life events or traumatic experiences
- general emotional stress
- anger and hostility
- work stress
- distressed sleep
Researchers from the University of Amsterdam in the Netherlands have suggested possible explanations for how different types of stress can give rise to diabetes. These include lifestyle factors, effects on hormone levels, and effects on the immune system.
These explanations for how stress affects diabetes are only theories. Some researchers have even found conflicting evidence that diabetes and stress are related. For these reasons, researchers must continue to study these two conditions to determine if and how they are related.
We provide more details of these three factors in the sections below:
Stress affects lifestyle factors
High levels of stress may cause a person to engage in unhealthful lifestyle habits. These lifestyle habits can increase a person's risk of developing diabetes. They include:
- eating a poor quality diet
- low exercise levels
- excessive alcohol consumption
Stress affects hormones
Another explanation is that emotional stress can affect a person's hormone levels, potentially disrupting how well insulin works.
Stress can activate the hypothalamic pituitary adrenal axis and the sympathetic nervous system. This can cause hormonal changes, such as higher cortisol levels and lower levels of sex hormones. The levels of these hormones affect insulin levels.
Cortisol is commonly known as the stress hormone. It can also stimulate the production of glucose in the body and raise a person's blood sugar.
People with abnormal hormone levels may notice their waist-to-hip ratio increasing. An increased waist-to-hip ratio means that the size of the waist is becoming larger than the hips. This is an important risk factor for diabetes and cardiovascular disease.
Stress affects the immune system
Chronic stress may also affect the immune system.
In one study, researchers noticed that a particular immune system response to chronic stress is a similar response to one that is involved in the development of type 2 diabetes.
How can I tell if stress is affecting my blood sugar levels?
To determine if stressful events are causing an increase in blood sugar, people can measure their blood glucose throughout the day. They should note how they are feeling and when they last ate.
People can then show their readings to their doctor for analysis.
If the doctor notices that stress may be affecting blood sugar, they can explore different techniques to help a person control their stress levels.
Reducing stress levels
A person who feels stressed may find mindfulness techniques to be beneficial.
The American Diabetes Association recommend that people with diabetes take care of their mind just as much as they do their body.
Stress can be both a contributor to diabetes and a consequence of it. However, there are many effective ways to relieve stress.
The strategy that works best for one person may be different for the next person. Exploring different options can help a person find the strategy that works best for them.
A 2018 study that took place in a clinic in Iran found that taking part in social-related stress management training could improve blood sugar control in people with diabetes. Stress management techniques may help people manage their glycated hemoglobin levels.
Doctors use glycated hemoglobin levels to assess a person's blood sugar control over the past 3 months. Improving glycated hemoglobin will decrease the risk of experiencing diabetes-related complications.
People with diabetes and stress may have lower glycated hemoglobin levels if they practice techniques that reduce stress. Strategies that increase their coping self-efficacy and their perceived social support can be effective. Below are some examples to try:
Researchers have studied mindfulness based stress reduction techniques in people living with diabetes.
In a 2018 study, 29 people with diabetes received mindfulness sessions and education, while 30 people in the control group did not. People who received the training had significant improvements in their mental health outcomes and diabetes management measures, including fasting blood glucose and glycated hemoglobin.
People with diabetes who are feeling angry should try to figure out why they feel this way.
Understanding the cause of anger is one step in the right direction to resolving the issue. The American Diabetes Association provide the following tips for controlling angry feelings:
- Take a breath or take multiple deep breaths, if needed.
- Drink water.
- Sit down.
- Lean back.
- Shake the arms loose.
- Try to silence the mind.
- Take a walk.
Stress reduction strategies
Regular exercise is an effective way to reduce stress.
The American Psychological Association recommend the following stress reduction strategies:
- Try taking a short break from the stressor, which might a big project or a growing credit card bill, for example.
- Exercise as often as possible, such as by going for a 20 minute walk, run, or swim.
- Smile and laugh to release stress from the muscles of the face.
- Seek social support from a friend or family member.
- Try meditation or mindfulness.
Researchers suggest that stress can be both a contributor to and a consequence of diabetes. People who are stressed may have higher levels of certain hormones that can affect how insulin works.
High stress levels can also lead to unhealthful lifestyle habits, which can, in turn, increase a person's risk of developing diabetes.
Although researchers have many theories as to how diabetes and stress are linked, the actual pathways that connect the two conditions remain unknown.
People with diabetes may wish to seek help in reducing their stress. Researchers have studied different techniques, and many agree that stress reduction has positive effects on blood glucose control.
If stress management techniques are not effective, or if a person is starting to show signs of depression, they should see a doctor. A psychotherapist or a counselor can help people manage their mood.
Stress reduction techniques may work for some people but not others. Stress may also have different effects on each person. If a person is living with both diabetes and chronic stress, they can explore different strategies to relieve stress and help control blood sugar.