Is Stress the Source of Your Blood Sugar Swing?A catty co-worker, an unpaid credit card bill, planning a wedding — if something causes you stress, it can also trigger an increase in your blood sugar level.
If you have type 2 diabetes, you know that certain foods — particularly foods that are high in carbohydrates — can send your blood glucose (sugar) level through the roof. But did you know that there’s a long list of other factors — such as too little sleep, illness, even monthly menstrual cycles — that can sabotage your best efforts to control your blood sugar?
High on that list, though you may not be aware of it, is stress.
Whether it’s related to work, to relationships, or to some other aspect of your life, research, according to the American Diabetes Association (ADA), has continually shown that emotional stress can cause blood sugar to surge. And since strict blood sugar control is the key to the successful management of type 2 diabetes, it’s important to understand how stress affects you and to find healthy ways to cope when mental distress mounts.
The Effect of Stress on Blood Sugar
According to the ADA, stress triggers an increase in the body's fight-or-flight hormone levels, as if the body were under attack. In response, the body releases extra energy in the form of glucose and fat. People with diabetes are unable to properly process that glucose because of insulin resistance, and consequently glucose builds up in the blood.
“For someone who doesn't have diabetes, stress causes a temporary rise in blood sugar, but their body can adjust,” says Amy Campbell, RD, LDN, a certified diabetes educator and a contributor to DiabetesSelfManagement.com. “For someone with diabetes, the blood sugar level stays high.”
Everyone gets stressed out at times, but it’s important to understand that there’s a difference between short-term and long-term stress, says the ADA. While life’s inevitable short-term stressors — getting stuck in traffic, bickering with a family member — cause a temporary rise in blood sugar, it’s the long-term stressors, such as an unhappy marriage or a cruel boss, that can cause serious damage.
What’s more, stress can start to undo the routines you put in place to manage type 2 diabetes. “You may start to eat more, change your behavior, or exercise less,” says Renata Belfort De Aguiar, MD, PhD, an assistant professor of medicine, in endocrinology, at the Yale School of Medicine in New Haven, Connecticut. Campbell agrees: “Not only does long-term stress cause chronic high blood sugar but it can affect how you take care of yourself.”
Is It Only “Negative Stress” That Affects Blood Sugar?
Even positive life changes can cause blood sugar to swing, Campbell says. Planning a wedding, moving to a new city, getting a job promotion — such “happy stressors” can also send your fight-or-flight hormones into overdrive.
A large review of studies on stress and blood sugar published in Diabetes Spectrum cited the definition of stress as the “physiological or psychological response to an external stimulus,” regardless of whether that stimulus is good or bad. That means that if you experience a significant change in your life — whether it's positive or negative — it’s a good idea to keep an extra-close watch on your blood sugar.
10 Ways to Maintain a Healthy Balance
It's not possible, of course, to eliminate all of life’s headaches. But you can take steps to gain better control over both your blood sugar levels and your stress levels. Start here.
When stress strikes, closely monitor your blood sugar. “When you’re stressed, you should be monitoring and checking your sugars to see if the stress is having an effect or not,” Dr. Belfort De Aguiar says. Simply being aware that stressful situations can affect blood sugar can prepare you to make adjustments. “When you’re under a lot of stress, that’s when you want to be really on top of your blood sugar,” Campbell says. “It’s the time to hone your self-care behaviors.”
Fill your doctor in on big life changes. If a stressful situation is causing your blood sugar to swing, your diabetes doctor needs to know. Says Campbell, “Your doctor may temporarily change your diabetes medication or put you on a higher dose. If necessary, he or she can even make a referral to a mental health professional.”
If possible, eliminate long-term stressors — for your health’s sake. According to the ADA, too much stress can be a warning that something needs to change. Since long-term stressors affect your long-term blood sugar levels and can cause damage to your overall health, they’re even more worthy of a reevaluation. Is it your job that’s tipping you over the edge? If so, the ADA suggests that you have a conversation with your boss on how to improve your work environment, apply for a transfer, or even start the hunt for a new job.
Cut back on short-term stressors, too. Minor annoyances have only a minor effect on your blood glucose level, but when the annoyances are strung together day after day, that effect can mount, says the ADA. Be mindful of little things that consistently get under your skin and try to avoid them. For example, if your highly trafficked commute to work drives you crazy, search for a route with less gridlock, or try getting an earlier start to beat the rush.
Arm yourself with (healthy) quick fixes. The toll stress takes on your health largely depends on how you react to it, Campbell says — “We can’t always avoid being stuck in traffic.” We can, however, learn how to take small stressors in stride. Campbell suggests that you rely on a few quick fixes to help you cool off: “Maybe you go for a walk to clear your head. Maybe you treat yourself to a massage or a manicure. Or maybe you just talk to someone about it.” Focusing on your breath is another simple way to calm your mind and body, wherever you are.
Practice relaxation. Whether you choose deep-breathing exercises, meditation, or aromatherapy, relaxation techniques are designed to help you reduce stress. In fact, a study presented at the 2015 annual meeting of the Endocrine Society showed that mindfulness-based stress reduction (which involves breathing exercises and the practice of nonjudgmental awareness of one’s thoughts) was beneficial in managing blood sugar. The researchers followed 86 overweight women, half of whom were assigned to 16 weeks of training in mindfulness-based stress reduction. Compared with the control group (who did not receive the training), these women exhibited significant reductions in both stress and fasting blood glucose levels. Explore a variety of relaxation techniques, Belfort De Aguiar suggests, to find one that works for you.
De-stress with exercise. Physical activity is crucial for people with type 2 diabetes for many reasons. In particular, exercise lowers blood sugar by increasing insulin sensitivity (meaning that the insulin does a better job of processing glucose), explains the ADA. But a good workout is also a great way to blow off steam and rein in stress levels. Even a quick walk can help — says Campbell, “Not only will getting out and walking remove you from a stressful situation but it can help improve your mood.”
Talk it out. Sometimes you just need to unleash your emotions. A family member, friend, or other source of support who will listen to you can make a big difference in the way you manage stress, Campbell says, adding, “You can also talk to a counselor or join an online support community.”
Beware of “diabetes burnout.” Living with type 2 diabetes can be stressful enough without allowing the management of the disease to become a major source of tension. Staying organized about all the aspects of your care — doctors’ appointments, at-home blood-glucose monitoring, medication schedules — can help. The ADA also recommends diabetes support groups — they allow you to talk to people who understand what you’re going through and to share management and coping advice.
Recharge your batteries. Plenty of research shows that lack of adequate sleep can lead to emotional strain — for example, a study published in the Journal of Neuroscience in 2013 found that sleep deprivation was a contributing factor to anxiety disorders. What’s more, poor sleep may cause blood sugar levels to swing: A large study published in 2014 in Diabetes Care found that people with type 2 diabetes who slept less than 4.5 hours a night had higher blood sugar levels than those who slept 6.5 to 7.4 hours a night. Sleeping too much (more than 8.5 hours) was also associated with higher blood sugar. “Getting enough sleep can help your diabetes management,” Campbell says. If you’re not sleeping well at night, discuss the matter with your doctor.
How Not to Deal With Stress
Food, alcohol, self-pity: These unhealthy “coping” mechanisms do more harm than good. “When we’re stressed out, we turn to unhealthy food — comfort food — and we may start eating a lot of sweets,” Belfort De Aguiar says. “We don’t leave the house.” These are the wrong ways to cope with stress.
Campbell also warns against keeping your emotions bottled up inside. “Be sure to share your stress,” she says, “even it just means having someone listen to you vent.”