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Dear Diabetes: Emotions and Blood Sugar

Do emotions affect blood sugar?

Dear Diabetes: I’ve heard that your emotions can affect your blood sugar levels and vice versa. How does that work?

If you have any doubt that numbers can be emotional, look no further than your bathroom scale. Who hasn’t, like me, felt a drop in their stomach when the number is higher than desired, or a rush of satisfaction when it’s in the target range?

Living with diabetes may, unfortunately, make your relationship with numbers even more fraught. Instead of seeing your “score” every day or week on a scale, diabetes offers constant opportunities to judge yourself by the numbers. There’s the number of your hemoglobin A1C test. The numbers that pop up when you prick your finger for a blood sugar check. If you wear a continuous glucose monitor, which provides a flow of near real-time data, you may get a new opportunity for numerical self-judgment every five minutes of every day!

All this constant self-evaluation – and with it, the possibility for emotions like guilt, frustration, anger, and failure ­– may sometimes lead to an under-discussed aspect of diabetes care: emotional management, where you may feel you’re a permanent caregiver of yourself. This chronic emotional toll may have consequences, like raising your risk of depression, or causingdiabetes burnout,” where you feel like you just can’t handle the everyday self-management tasks anymore.

Unfortunately, the effects of diabetes-related emotions don’t stop with your mood: Not only can the burden of diabetes sometimes cause negative emotions, but negative emotions – whether they’re caused by diabetes or other external stressors – may sometimes make your diabetes harder to manage.

One way that negative emotions cause physical effects is by preventing you from taking care of yourself: If you’re depressed, for example, it can become harder to eat healthily and stay active, two crucial aspects of blood glucose management.

But there’s a biochemical component, too. Whether they’re directed at ourselves or others, negative and stressful emotions like anger or frustration or sadness can drive up levels of stress hormones in the body like epinephrine and cortisol. These hormones are part of our bodies’ fight-or-flight response, designed to help us survive in times of crisis by making glucose readily available for our bodies to use as fuel. Unfortunately for people with diabetes, these hormones also make muscles and tissues more insulin-resistant – that is, less efficient at removing glucose from the blood stream. This extra burst of glucose, combined with a less effective use of insulin, can contribute to high blood sugar.

This can start a dangerous feedback loop: Frustration and anger at diabetes can drive your blood sugar up, which makes you more frustrated and angry, which can increase your insulin resistance (and blood sugar) even more. It’s the diabetes equivalent of an escalating schoolyard fight, and it’s important to find a way to intervene.

If the emotional weight of diabetes is becoming too much for you, talk to your diabetes care team and consider finding some support resources online, whether for those living with diabetes or for those who love and support them.

Catherine Price is a freelance journalist and type 1 diabetic who has written for The New York Times, Slate, Popular Science, and O Magazine, among others. She blogs about diabetes at asweetlife.org and you can follow her on Twitter @Catherine_Price. Price is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewee, and not of Sanofi US, its employees, agencies, or affiliates.

© 2013 The DX: The Diabetes Experience

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