Did Stress Cause Your Diabetes?
By the very nature of our fast paced society, feelings of overwhelm are quite the norm for the average “Jane” & “Joe”. Whether it’s those emotional family interactions, career obligations, household responsibilities, self-inflicted stress, societal pressures, politics, concerns over catching the Zika Virus, or increased safety risks from terroristic activity, there is always something taking up unwanted space in our minds. Many of these worries lead to chronic stress and anxiety that unknowingly destroy our bodies from the inside out, slowly damaging our nervous system. Although emotional and physical stress is considered normal, prolonged and increased levels can take a toll on the health of anyone, particularly those living with Diabetes. Already fighting to maintain normal blood sugars, research is showing a direct correlation between increased stress levels and hyperglycemia for people with Diabetes. If you ever notice unexplained fluctuations in your blood sugars, stress could, unknowingly, be the root cause. So the big question is, “Does Stress raise blood sugars” and “Did it cause my Diabetes”?
According to a Dr Hans Selye who published ‘The Stress of Life’, the effects of stress varies depending on the intensity and the length of it. In his book, Dr Selye recognizes that the right amount of stress, which he calls ‘optimal stress’, increases focus and maximizes performance. On the other hand he attributes too much stress to feelings of unhappiness and anxiety. Recent research has shown that not only can your mood be effected, stress causes a physiological response within the body that leads to other health complications, even disease.
Dr Selyes stress model suggests that at its ‘optimum level’ stress is beneficial, but, beyond that, the body resists and ultimately wears out. For some of us, when we exceed that “optimal level” threshold, the result is an unpredictable wave of highs and lows sending our bodies and blood sugars down a very dangerous path. Additionally, our immune system becomes compromised making us more succeptible to illness and disease. When I look back at my life, I would say that the times where I ended up becoming sick were almost always the times in my life when I was under the highest levels of stress for an extended period of time.
The reality is that we all respond differently to stress. Some of us can handle what would be considered extremely high and unbearable stress to most. It’s our own individual response to stress that determines the impact this has on our body. While some people can thrive and perform optimally under stress, others crash and burn as their blood sugars skyrocket. Since stress is subjective and individual responses differ greatly, providing a “one size fits all” solution to dealing with stress and its impact on your blood sugars has proven difficult.
However, since more and more research is showing a connection between hyperglycemia and stress, the first step in recognizing any connection between stress and normal blood sugars is to simply start with being aware of the connection in your own experience. If you are seeing a spike in blood sugars or experiencing hyperglycemia, take note of your emotions that day or for a few hours preceding the high reading, and document this either in a notebook or using an online logbook. Start to recognize patterns. While you may not be able to get a definitive answer, research is absolutely showing that stress has a significant impact on blood glucose levels as well as on blood pressure. Capturing your own patterns will definitely provide you with insight into the impact stress has on your blood sugars. This article attempts to thoroughly detail how stress impacts diabetic patients negatively by causing hyperglycemia or potentially even stress induced Diabetes. At the end of this article we hope to answer important questions about whether stress impacts your Diabetes, and if it does, what you can do about it. You will also discover effective stress management techniques that you can employ to help reduce stress and see the impact it has on your blood sugars and overall health.
What is stress and why does stress affect Diabetes?
Stress is the humans’ body physical response to any demand or potential threat. When stressed, the human body goes into a ‘flight or fight’ mode. As a result, your body releases chemicals and hormones such as cortisol, adrenaline and epinephrine which primarily prepares the body for physical action. A rise in blood sugars or hyperglycemia is a direct result of the overproduction of these stress hormones. Hormones like epinephrine and cortisol boost blood sugar levels to help boost energy levels in readiness for ‘fight or flight’. The net impact of these hormones being secreted into the body is an increase in stored energy levels in the form of glucose and fat preparing the body to deal with the threat. Non diabetic people can cope with stress because they have the compensatory mechanisms that keep blood sugar in check. Someone with Diabetes lacks these mechanisms because of their insulin resistance which diminishes its capacity to push this energy into the cells causing glucose to pile up in the blood stream. Stress induced diabetes increases blood glucose levels making it harder for diabetics to maintain normal blood sugars. Under stress, your body naturally becomes more insulin resistant. Someone who is under consistent amounts of stress experiences these cycles repeatedly.
Cortisol levels significantly reduce insulin sensitivity leading to increased blood glucose levels while epinephrine can stimulate glucogeneogenesis (production of glucose by the liver). When this glucose is released into the bloodstream, it causes a further increase in blood glucose levels. Furthermore, these hormones also trigger the release of fat from fat stores leading to increased triglyceride and blood fat levels, increasing vulnerability to high blood pressure. High blood pressure coupled with high blood glucose levels are detrimental to people living with diabetes and can worsen ones health condition significantly.
Can consistent elevated stress levels cause Diabetes?
Stress induced diabetes was just a theory but several studies have been done to determine if stress is indeed a precursor for Diabetes. A study done in Sweden which followed 0ver 5200 adults for a period of over 8 to 10 years conclusively established that elevated emotional stress levels had twice the risk of developing pre-diabetes. Additionally people with consistent high emotional stress levels also had 3 times the risk of developing Type 2 Diabetes as compared to those with normal stress levels. Two recent studies also prove that high stress level are a precursor for Diabetes Type 2; based on an extensive epidemiological study by Knot et al.(2006) and another extensive study by Mezuk et al. (2008) consistent elevated stress levels cause Diabetes type 2. Mezut et.al (2008) included a total of 13 studies which investigated over 6,916 cases to ascertain if stress was a risk factor for diabetes. A meta-analytic review of this studies showed that incidences of diabetes were 60% higher in people with high stress levels as compared to those with normal stress levels.
Other Short term and long term health issues related to diabetes and stress induced higher blood sugars-
Chronic elevations of cortisol, epinephrine and norepinephrine which are released when the body is under stress have effects on multiple body systems. Some of the effects of stress induced diabetes are listed below:
When epinephrine and norepinephrine levels rise to extreme levels, blood flow is shifted away from the digestive organs and this significantly reduces digestive processes such as nutrient absorption and enzyme production. In high concentration, stress hormones have the potential of increasing the permeability of the digestive tract meaning that foods meant to be kept in our digestive tract for digestion break through the digestive tract’s lining. This can cause proteins and other foods that are not easy to digest to enter the blood stream. Since stress hormones hinder the normal digestive processes they, ultimately, have an undesired impact on the blood glucose levels, especially in people with diabetes.
Stress hormones also have a negative impact on the immune system. When stressed, the human body has reduced response to viral attacks. For instance cortisol triggers the immune system to produce pro inflammatory cytokines, called TNF-alpha, which negatively impacts the body’s immune system. TNF-alpha also affects the body’s metabolism and affects other body hormones. TNF-alpha inhibits testosterone and DHEA formation while increasing production of estrogen like hormones. Since testosterone assists in maintaining glucose-requiring lean muscle, a decrease in testosterone levels can lead to increase in blood glucose which is detrimental in people suffering from diabetes.
TNF-alpha significantly reduces insulin production by the pancreas and this is detrimental for people with Diabetes who already suffer from insulin deficiency. Since insulin controls blood sugar levels, when in short supply a person with Diabetes will need more insulin supply that may not be sufficiently provided by their medication. Insulin shots for diabetics are meant to supplement the little insulin that a diabetics body can produce naturally, if this natural production of insulin is further hindered then it becomes more difficult to maintain a normal blood sugars.
Cortisol can increase blood glucose levels by reducing sensitivity to insulin making it hard to maintain normal blood sugars. When insulin sensitivity is reduced, the blood glucose remains in bloodstream for a longer period of time and is rarely absorbed into the body muscles and other tissues. Therefore, insulin insensitivity not only reduces glucose supply to body tissues and muscles but also hinders the efficiency of insulin medication that is administered to patients suffering from diabetes. If your insulin medication fails to work as required because of insulin resistance then a person with Diabetes is at high risk of hyperglycemia which can worsen their health and make it hard to maintain normal blood sugars.
Hyperglycemia can cause the cells in the walls of blood vessels to be overloaded with glucose. When this glucose overload persists for a long time, the blood vessels get damaged because the walls thicken and weaken overtime. As a result of thickening of the blood vessels, blood flow to organs that are supplied with small blood vessels such as the nerves is hindered. Consistent unlimited supply of blood to nerve cells hinders efficient functioning of the nervous system.
Effective Stress Reduction Techniques that can help in the Management of Diabetes
As already established above, stress induced diabetes is proven medical occurrence that can increase the likelihood of getting Diabetes. Proper stress management techniques are indispensable for people with Diabetes who aim at maintaining a low blood sugar level and also for non-diabetic people who want to alleviate the possibility of getting diabetes because of stress. An exhaustive study by Surwit et al. in 2002 ascertained that stress management training does indeed help to reduce blood sugar levels. According to this reliable study, people with Diabetes who received stress management training had approximately 0.5% reduced blood glucose level as compared to counterparts who did not receive any stress management training. This study unequivocally establishes that if you have Diabetes or Pre-Diabetes it is crucial that you take measures to manage stress in order to avoid increased blood sugar levels that can be spiked by high level of stress. Here is a brief but detailed rundown of effective stress management techniques that will come in handy in preventing stress induced Diabetes and in maintaining normal blood sugars.
Having a regular Tai Chi regimen
Tai Chi is actually one of the most studied stress reduction therapies in Type 2 diabetes management. Tai Chi is a movement based therapy that focuses on long fluid movements that are accompanied by intense breathing exercises. For Tai Chi to be effective in the reduction of blood glucose levels, it has to be done intensely over a long period of time. A recent study on the effectiveness of Tai Chi in reduction of blood glucose levels in people with type 2 Diabetics had remarkable results; after an intense Tai Chi regimen featuring 2 Tai Chi sessions in a week for 6 months the participants not only reported reduced HbA1c and fasting blood sugar but also had a general improvement in their quality of life.
Yoga is essentially a movement based practice that features different styles which require different degrees of physical fitness. Just like Tai Chi, Yoga also incorporates breathing exercises. Although very few recent studies of Yoga in type 2 Diabetes have been published in the United States, a recent uncontrolled study in India published by Singh et al established that yoga substantially boosts the reduction of fasting blood sugar levels and HbA1c level (fasting blood sugar reduced by an average of 50mg/dl while HbA1c levels reduced by 1.2%. Although the results of this study are not unequivocal because its uncontrolled nature, the degree of improvement is incredible. Based on these remarkable results, it is safe to say that yoga plays a role in the management of stress that can spike high blood glucose levels. Regularly practicing yoga can help prevent hyperglycemia and help in controlling normal blood sugars.
Regularly practicing Qigong
This is yet another breathing practice that has a movement component. Qiqong unlike Tai Chi features fewer repeats and smaller body movement. It can also include hand-on therapies and massages coupled with visualization exercises, An uncontrolled study done by Bastyr University in Seattle, WA which was published by Tsujiuchi et al. in 2002 showed that Qiqong helped in the management of blood glucose levels for persons with Type 2 Diabetes. After regular sessions of Qiqong for 4 months, the participants dad an average reduction of 0.8% in HbA1c and also had higher insulin secretion levels together with decreased anxiety levels. Therefore, Qiqong can help prevent hyperglycemia and also help maintain normal blood sugars.
Reliable and extensive studies on meditation have also established that meditating can improve insulin resistance, reduce stress and significantly improve quality of life by creating self awareness in an individual. Although in the current fast-paced society, the idea of taking 10 minutes daily to sit silently and focus may sound like a novel concept, research proves that meditation helps to focus and calm the mind. By mediating regularly, a diabetic will be able to think through before acting. Mastering self control decreases the likelihood of grabbing ice cream when stressed and increases the likelihood of willingly adhering to a healthy diet and an effective exercise regimen that can help maintain normal blood sugars. Diabetes self-care requires self-discipline and commitment which can be achieved through the self control and self awareness that meditation instills in an individual. By meditating daily, you are decreasing your vulnerability to stress induced diabetes considerably.
Below is an infographic about Stress Reduction ideas containing great tips on how you can maintain your stress level.
Surround yourself with a great support network and connect with others dealing with struggles you can identify with
A good support network is indispensable in the management of diabetes because loved ones essentially reminds you that you are not alone and there are many people who go through struggles similar to yours on a daily basis. Relating and interacting with such people helps to encourage you and keep you on track with your medication, exercise regimen and diet plan. Nothing is more stressful than feeling alone and unsupported. Having a good laugh with friends and a word encouragement from a person who is also diabetic can go a long way in calling anxiety and reducing stress. Fight stress induced diabetes by making meditation part of your daily routine. Contact with other diabetics will enable sharing of tips and techniques that come in handy in maintaining normal blood sugars and preventing hyperglycemia.
Embrace a positive attitude and accept the things that you cannot change
Diabetic management is a daily routine that requires commitment and consistency and it is quite common to develop extreme anxiety about living with a condition that requires a daily conscious effort to remain healthy. To counter this anxiety, a diabetic person has to accept that they are sick and develop a positive attitude that will carry them through everyday struggles with this debilitating illness. Instead of focusing on how difficult it is to live with diabetes, how about focusing on the little achievements you make on a daily basis such as sticking to your diet and exercising. Take time and appreciate the good things in your life such as family and friends instead of focusing on the things you cannot control. With acceptance, maintaining normal blood sugars will cease being a difficult task.
Sleep for an adequate amount of time everyday
Sleep deprivation is has detrimental effects that increase stress levels such as negatively affecting judgment, mood and memory. Not getting enough sleep leaves a person irritated hence easily affected by insignificant stuff. Adequate sleep not only allows your body to rest but also allows the brain the recharge. By sleeping adequately, a diabetic remains in the right state of mind to maintain a healthy diet, a good exercise regimen and a positive attitude that takes them through the day stress-free.
Adopt a reasonable non-strenuous exercise regimen
When exercising, the body naturally produces endorphins which not only act as natural painkillers but also improve sleep leading to reduced stress. Additionally, exercise also helps maintain a desirable body weight that makes a person more confident in their looks. When you feel good about your appearance it fuels your motivation to eat more healthily and adhere to a healthy lifestyle that can keep your blood glucose in check. People suffering from diabetes type 2 have a hard time maintaining normal blood sugars. A good exercise regimen comes in handy because it can reduce blood sugar levels since muscles use up blood glucose during exercise. Exercise reduces blood glucose levels despite insulin levels. Additionally, regular exercise also helps maintain a normal body weight which is important for diabetic patients.
Reliable statistics estimate that by 2012 approximately 9.3% of the American population had diabetes and the numbers are increasing on daily basis. The prevalence of diabetes is astounding and this potentially dangerous health condition is further worsened by stress. A thorough understanding of stress induced diabetes coupled with knowledge on how to properly manage stress helps diabetics to manage their illness more effectively and alleviate the possibility of developing irreversible health complications. Maintaining normal blood sugars and preventing hyperglycemia is a daily struggle for diabetic patients and this can be made easier by simply reducing stress levels. Start your practice today! If you are doing anything now that helps you better manage your stress, please share what works for you in the comments section.