‘Stress’ is a general term applied when the body has to adapt or react to a difficult situation. Stress may be physical as in illness or injury, or mental such as that caused by anxiety or worry.
When the body is under stress, many hormones are released which oppose the action of insulin. The purpose of these hormones is to release energy in the form of glucose and fat which is made available to the cells of the body. This provides fuel for what has been traditionally referred to as the ‘flight or fight’ response.
These include adrenaline and glucocorticoid or steroid hormones, which are secreted by the adrenal glands and growth hormone produced by the pituitary gland.
Stress may affect the body in two separate ways. As described above, the release of ‘stress hormones’ which antagonizes the action of insulin, helps increase levels of blood sugar.
People under stress may be unable to look after themselves; they may forget their medications such as insulin and also be unable to exercise due to injury. They may drink too much alcohol or smoke excessively. Many people who are under stress turn to food as a source of ‘comfort’. This pattern of ‘comfort eating’ can often play havoc with your blood sugars!
No. There is no evidence that stress causes diabetes. However, stress may sometimes unmask diabetes, by causing blood glucose levels to rise. This is often seen after a heart attack or stroke, where raised blood sugar levels may be encountered for the first time.
Many forms of stress are difficult to predicit, such as illness or injury. Mental stress can be sometimes minimised by changes in lifestyle. Make sure you have adequate exercise, leisure time and sleep. Relaxation techniques and exercises may also help.
The diagnosis of diabetes usually comes as a shock and is certainly a stressful time. Changes in lifestyle diet and learning to manage your injections may all contribute in addition to the worry regarding chronic illness. Having to stop smoking may be an additional source of stress. If necessary you should postpone this for a more suitable time.
The stress caused by this condition can be greatly reduced by learning how to manage and control your diabetes. Your diabetes team will be able to help you deal with these issues in more detail.
Yes, there is evidence that mental stress can elevate your glucose levels.
People who are anxious sometimes seek refuge in food and drink. This can take the form of chocolates, sweets and crisps, often in between meals. The intake of alcohol may be increased. The results can be disastrous for people with diabetes. People with Type 1 diabetes may develop elevated blood glucose levels and ketoacidosis. Those with type 2 diabetes usually gain weight and develop obesity. If you find you are doing this, discuss the problem further with your doctor who will refer you to a dietician and a psychologist if necessary.
Map out your day. Identify clear times for exercise and relaxation. Plan meal times and avoid eating and injecting ‘on-the-run’. Make a list of all the things you find stressful within your day whether it is work, personal relationships or injections. Work out ways of reducing the stress caused by these issues. Discuss this further with your doctor or diabetes nurse.
We at the West Suffolk are continually looking at reducing the stresses of living with diabetes. This website was created as part of that, in providing support through education. We are currently looking at the feasibility of creating ‘support groups’, which may further help lighten the load of diabetes.
Dr Nishan Wijenaike, Consultant Physician
West Suffolk Diabetes Service