• Dr. Eric Carlsen

Is Stress the Source of Your Blood Sugar Swing?


A rope about to break with the word STRESS in the middle

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 stabilize 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 has continually shown that emotional stress can cause blood sugar to surge, according to the American Diabetes Association (ADA). And because consistent management of blood sugar is the key to living a healthy life with type 2 diabetes, it’s important to understand how stress affects you and to find healthy ways to cope when mental distress mounts.


That’s especially true right now when the novel coronavirus is top of mind and everyone’s stress level is sky-high. In addition to heightening health worries, the COVID-19 pandemic comes with immense economic and daily living stressors. Whether you’ve lost your job, are working from home, helping your kids with e-learning, or are quarantined by yourself, it’s natural to feel stress.


As if stress weren’t bad enough on its own, it can contribute to irregular blood sugar levels.


The Effect of Stress on Blood Sugar

Stress triggers an increase in the body's levels of the fight-or-flight hormone cortisol as if you were under attack, explains Roger McIntyre, MD, professor of psychiatry and pharmacology at the University of Toronto in Canada. In response, the body releases extra energy into the bloodstream in the form of glucose. (That way, in case you are under attack, you have the fuel necessary to fight or flee.)


“When chronically heightened, cortisol works against glucose control even in people who don’t have diabetes,” Dr. McIntyre says. Yet people with diabetes are unable to properly process and store that glucose because of insulin resistance, meaning that glucose accumulates even more in their blood in times of stress.


Everyone gets stressed out at times, but it’s important to understand that there’s a difference between short-term (acute) and long-term (chronic) stress, he says. While life’s inevitable acute stressors — getting stuck in traffic, bickering with a family member — cause a temporary rise in blood sugar, it’s the factors that can lead to chronic stress, such as an unhappy marriage, a cruel boss, or the COVID-19 quarantine, 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, Ph.D., 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.” This includes both your physical and mental self.


Diabetes is even considered to be an independent factor in the development of depression, according to an analysis published in June 2019 in Preventive Medicine Reviews. That means that if you take two otherwise identical people, the one with diabetes is significantly more likely to struggle with depression.



Is It Only 'Negative Stress' That Affects Blood Sugar?

Even positive life changes can cause blood sugar to swing, says Amy Campbell, RD, certified diabetes care and education specialist, and a contributor to DiabetesSelfManagement.com. 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 past review 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.

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