How Stress Affects Diabetes
In people who have diabetes, the fight-or-flight response does not work well. Insulin is not always able to let the extra energy into the cells, so glucose piles up in the blood.
Many sources of stress are not short-term threats. For example, it can take many months to recover from surgery. Stress hormones that are designed to deal with short-term danger stay turned on for a long time. As a result, long-term stress can cause long-term high blood glucose levels.
According to the American Diabetes Association, stress can alter blood glucose levels for three reasons:
1. People under stress may not take good care of themselves. They may drink more alcohol or exercise less.
2. They may forget, or not have time, to check their glucose levels or plan good meals.
3. Stress hormones may also alter blood glucose levels directly.
Scientific studies
Scientists have studied the effects of stress on glucose levels in animals and people. Diabetic mice under physical or mental stress have elevated glucose levels. The effects in people with Type 1 diabetes are mixed. While most people's glucose levels go up with mental stress, others' glucose levels can go down. In people with Type 2 diabetes, mental stress often raises blood glucose levels.
Physical stress, such as illness or injury, causes higher blood glucose levels in people with either type of diabetes.
For some people with diabetes, controlling stress with relaxation therapy seems to help. It is more likely to help people with Type 2 diabetes than people with Type 1 diabetes. This difference makes sense. Stress blocks the body from releasing insulin in people with Type 2 diabetes, so cutting stress may be more helpful for these people. People with Type 1 diabetes don't make insulin, so stress reduction doesn't have this effect.
However, reducing stress can help people with Type 1 diabetes take better care of themselves. In addition, some people with Type 2 diabetes may also be more sensitive to some of the stress hormones. Relaxing can help by blunting this sensitivity.
It's easy to find out whether mental stress affects your glucose control. Before checking your glucose levels, write down a number rating your mental stress level on a scale of 1 to 10. Then write down your glucose level next to it. After a week or two, look for a pattern. Drawing a graph may help you see trends better. Do high stress levels often occur with high glucose levels, and low stress levels with low glucose levels? If so, stress may be affecting your glucose control.
Diabetes-related stress
Dealing directly with diabetes-related stress can help. Think about the aspects of life with diabetes that are the most stressful for you. It might be taking your medication, or checking your blood glucose levels regularly, or exercising, or eating as you should. Ask a member of your diabetes team to help you
find a physician if stress is so severe that you feel overwhelmed. Then, counseling or psychotherapy might help. Talking with a therapist may help you come to grips with your problems. You may learn new ways of coping or new ways of changing your behavior
Help available
Trying to cope with your own personal diabetes crisis? "Zen and the Art of Diabetes Maintenance" by Charles Creekmore (pub. 2002) is part how-to book, part memoir and part inspirational tract. Learn how to manage your emotions, ambitions, fears and hopes! It is available for $15.95 from the American Diabetes Association, 1-800-DIABETES (1-800-342-2383) or online at
www.diabetes.org.
Find a physician who specializes in helping patients manage diabetes. And help yourself with these
stress reduction tips.
