Stress is a subject that seems to be a part of routine conversation these days. How many of us start a conversation with “I’m so stressed out with…” well, you fill in the blank!

We have traffic congestion, deadlines and appointments, meal planning, preparation and cleanup, and for people with diabetes, all this and worries about blood sugar control too.

From the time of the “caveman” days, our bodies have been equipped to deal with stress, whether it’s an immediate stress such as an animal chasing you or an “imagined” stress such as wondering how many unexpected holiday guests you will have. The first response to stress is known as the “fight or flight” response which stimulates the release of cortisol and norepinephrine hormones into your blood when your brain perceives that a stressful event has occured. This response helps the body cope with an immediate threat, increasing blood pressure and awareness which gives the body the ability to run or fight, whichever is appropriate for the situation.

The problem is that when faced with chronic worries or stressors, the body continues to release these hormones, which can cause defects in the immune system, higher than normal blood pressure, sleep disturbances, and even increase the aging process (1). Stress, or cortisol, will also cause blood sugars to rise, as you may have already noticed. High blood sugars can lead to even more stress and feed a vicious cycle in a person with diabetes.

Things that may cause blood sugars to fluctuate:

  1. Chronic or acute pain
  2. A sudden lifestyle change such as moving or divorce
  3. Surgery (many patients with diabetes not currently on insulin require insulin for a time after surgery)
  4. Illness such as the flu or bronchitis
  5. Strength Training (can potentially cause blood glucose surges)
  6. Taking tests/exams
  7. Family turmoil

Practicing ways to reduce your level of stress will help keep blood sugars in control. The importance of regular exercise, apart from helping with weight reduction, is to increase the level of endorphins, also known as  ‘happy’ hormones, in the body.

Let us not forget that the additional stress of managing diabetes can also have a strong impact. Diabetes Related Stress, also known as DRS, is associated with feeling frustrated with the numerous constraints of diabetes management such as blood sugar testing and dietary restrictions (2). This stress can be alleviated by enlisting the help of a caring healthcare team and by attending support groups facilitated by diabetes organizations in person or virtually. Check out this one through the ADA website, although many others exist as well. https://community.diabetes.org/home

It is important, therefore, to minimize stress where we can. This is easier said than done, right? But there are ways to help derail the stress response so that we can stay healthier and keep blood sugars under control.

One of the first steps is recognizing your personal triggers for stress. We all have “hot buttons” that seem to make us feel more stressed. Once you recognize your own stress triggers, you can find a way to deal with them. Meditation, yoga, or talking to a trusted friend or partner can help a lot.

Finding creative solutions to solve problems before they occur may be a good strategy. For example, delegating meal preparation so you don’t take on all the responsibility.

Trying NOT to be superwoman or superman might help you handle stress. Asking for help is by no means a weakness, indeed, it takes a strong person to say, “I need a hand”.

To help with stress you need to develop a “me first” mindset. It’s not that you can’t take care of anyone else; it’s just that you need to be healthy physically and mentally to take care of others. Take a long walk, go shopping if that’s what you enjoy, get a massage. By treating yourself you will in turn be better equipped to take care of everything else. Pets are great stress relievers, and it has been shown that people who own pets can live longer (3).

To help alleviate stress, surround yourself with positive people; focus on things you can change and pamper yourself. Keep in mind that with all the technology available to these days, sometimes you need to shut down. Don’t watch emails constantly, and try answering texts at your leisure. Sometimes you need to make “interruption-free” time, even if it’s an hour or two. Read a book, try a new hobby, or watch a good movie. Use the Dario app too as a partner to help take care of your diabetes and stay well!!

If you are experiencing any mental stress, consider talking to your healthcare provider. “Diabetes Self-Management Education and Support” (DSMES) has been shown to reduce diabetes distress (4)

  1. Black PH. “The inflammatory response is an integral part of the stress response: Implications for atherosclerosis, insulin resistance, type II diabetes and metabolic syndrome X.” Brain. 
    Behav. Immun. 2003; 17:350–364.  
  2. Fisher L et al. The confusing tale of depression and distress in patients with diabetes: a call for greater clarity and precision. Diabetic Med. 2014; 31:764–72.  
  3. http://time.com/4728315/science-says-pet-good-for-mental-health/ 
  4. Diabetes Care 2020, American Diabetes Association.

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