Ask a Diabetes Nurse Educator

How does stress affect my glucose levels?

Stress is a feeling that we experience when faced with a challenging situation. The event that leads to the stress is called a stressor. This can be physical, like an injury or illness. Or it can be mental, such as problems in our personal life, or a fear of something.

When we are stressed, our body responds with the “fight or flight” mechanism. This is our body’s way of preparing us either to fight the stressor or run away from it. During this response, the body releases stress hormones like cortisol, glucagon and adrenalin.

Our body needs more oxygen and glucose to fight or flee. These hormones increase our heart rate, blood pressure and breathing so that our body can pump blood to our muscles faster, providing them with more oxygen.

Stress hormones also stimulate the liver to release stored glucose. Additionally, they make our body less sensitive to insulin – in other words they increase insulin resistance. As a result, the blood glucose levels rise to give enough energy for the body to fight or flee.

This response made perfect sense in our ancestors’ life when most stress was physical. If an animal was chasing them, they had to either run for their lives or fight back. However, in modern life most stress is mental which can’t be managed by fighting or running away.

The “fight or flight” response happens to everyone but does not cause significant problems with glucose levels for people without diabetes. In people with diabetes the pancreas may not produce enough insulin to move this extra glucose to the cells effectively. This can lead to high blood glucose levels.

Managing stress

The first step is to identify the stressor. Managing diabetes itself can be stressful for many people and there may also be stressors that are not related to diabetes. Sometimes identifying the stressors can be more challenging than managing them.

Two key ways of dealing with stress are:

1. Change the situation when you can; or
2. Change your response.

Here is an example.

Stressor: Managing diabetes medications, following healthy eating guidelines, meal planning and achieving recommended physical activity goals.

Change the situation

Possible approaches include:

• Using medication aids like a Webster pack to organise medication.
• Speak with your healthcare team to simplify your medication regimen.
• Work with a dietitian to develop a realistic meal plan.
• Work with an exercise physiologist to create a safe and practical exercise plan.

Change your response.

Some suggestions include:

• Stay calm where you can and take diabetes management one step at a time.
• Focus on small and gradual dietary change.
• Start slowly and build up on your activities.
• Seeking support from your health care team if you are overwhelmed.
• Believe in yourself and avoid negative self-talk such as “I can’t manage my diabetes.”.

Some practical tips to reduce stress:

• Exercise regularly
• Do activities that you enjoy e.g. gardening, knitting
• Try to learn new activities
• Spend time with your loved ones
• Get quality sleep
• Practice relaxation techniques like yoga, meditation and deep breathing
• Seek help from a health professional when needed.

Managing stress is not about being perfect – it’s about learning what keeps you going!

Author: Riby Kuriachan – Diabetes Nurse Educator at Diabetes Victoria

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