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Dear Diabetes: Does Stress Affect Diabetes?

The DX explains how stress may lead to physical effects

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Does stress affect my diabetes? How?

Stress is a tough term to define, yet some people know it when they feel it, with reactions that may include aching muscles, difficulties sleeping, and overreacting to minor triggers – say, someone cutting you off on the highway – with major emotions. But how might stress, which is invisible, intangible, and, unlike a piece of chocolate cake, indigestible, possibly affect your blood sugar level?

As it turns out, stress can affect your blood sugar in more ways than you might think. Stress on the body has actually served a purpose, equally useful to our ancient ancestors as to modern humans, in which nearly all body systems gear up and prepare our bodies to respond quickly to a threat. Imagine encountering an angry polar bear while out on a snowy hike, for example: your body will demonstrate what’s known as the fight-or-flight response. That is, your heart rate will speed up, your muscles will tense, and your body will pump out a cascade of hormones that release stored energy – primarily in the form of glucose – into your bloodstream. This satisfies the body’s need for a quick jolt of energy and focus so that you can defend yourself or, in this example, run away as quickly as possible.

If the affected person has type 1 or type 2 diabetes, however, this stress response system doesn’t always work as planned. This is because people need a hormone called insulin to actually absorb that surge of glucose that begins to circulate in the blood stream. When you have diabetes, your body either makes no (or too little) insulin or cannot process the existing insulin in your body. If the extra glucose from the stress response accumulates in your blood instead of being absorbed by your muscles, blood sugar levels rise.

Granted, in the polar bear situation, the threat is immediate and a person may not be thinking about his or her blood glucose. But our bodies are not very good at distinguishing between immediate threats – for which a fight-or-flight stress response is helpful – and long-term stressors, such as unreasonable work pressures or a sick family member. Like acute stress, these chronic mental stresses can also cause changes in hormones that can affect blood glucose and may lead to long-term difficulty in managing your blood glucose.

In addition to affecting insulin resistance, chronic stress can also simply wear you out, leaving you too exhausted to exercise, cook, or take proper care of yourself. If stress affects your ability to keep up your diabetes self-care, your blood glucose levels may rise. Knowing that your blood glucose is poorly controlled can result in even more stress.  It’s a nasty cycle.

Of course, as is often the case with diabetes, what’s true for one person may not be true for another: some people’s blood glucose levels may not respond to stress or may even potentially decrease. If you want to see what your personal reaction is, try this experiment: rank your stress level on a scale of 1-10 before testing your blood glucose. Write the two numbers next to each other, and after a week or two, check to see if there’s any correlation between high stress scores and high blood glucose levels (and vice versa).

If you see a connection, try to figure out several small ways to reduce your stress. Set aside several minutes a day for a healthy, stress-releasing activity, like taking a walk or sipping a cup of (sugar-free) tea. Plan a lunch with friends (social interaction may reduce stress) or consider signing up for a class in mindfulness-based stress reduction. If time is tight, try closing your eyes, taking three slow, deep breaths, and repeating to yourself some sort of stress-reducing mantra. One potential favorite?  “There is no polar bear.”

© 2012 The DX: The Diabetes Experience

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