Need help navigating life with diabetes? You can always Ask D'Mine!

Welcome again to  our weekly Q&A column, hosted by veteran type 1 and diabetes author Wil Dubois.

Today Wil's digging into the nasty specter of stress, and what it can do to your diabetes. 

{Got your own questions? Email us at AskDMine@diabetesmine.com }

Lacey, type 2 from Illinois, writes:When I ask about my glucose ups and downs, my doctor keeps talking about stress. Isn’t this more related to the meds I’m taking? I mean, can stress really have such a big physical effect on my diabetes?

 

Wil@Ask D’Mine answers: Actually, stress can have such a huge physical impact on diabetes that I’m getting stressed out just thinking about it. Oh, and lookie there: my blood sugar is going up. 

That’s because stress is sugar. Literally. But before I can take you through the biological nuts and bolts of how and why that’s the case, let’s break stress down a little better first, because there’s more than one kind of stress.

The American Diabetes Association makes the distinction between physical stress and emotional, or mental, stress. Physical stress happens when the body is taxed by injury or illness, while emotional stress is the type we most often think of: the boss is a jerk, your checking account is on fumes and your car is making that funny noise again, your insurance doesn’t want to pay for the type of insulin that works best for you, Red Bull just dropped your favorite sport, or you turn on the TV and that politician who drives you crazy is talking smack again. All of those kinds of things.

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I tend to break emotional stress down further, into acute stress and chronic stress. Acute stress is being stuck in a traffic jam. Chronic stress is being stuck in a bad marriage. 

But all of these stressors, physical and mental, short-term and long-term, absolutely have a physical effect on your diabetes, and do so largely though something called the fight-or-flight response. To understand that, we need to take a trip waaaay back into the depths of time, to the very dawn of our species. Consider the early human: No claws, no sharp teeth, not that all that strong, no tough hide, and generally—at least compared to other animals—not all that fast.

Now consider the environment that this defenseless, bipedal ape lived in: Lions, and tigers, and bears. Oh my.

We were ill-equipped to survive. But guess what? Who rose to the top to rule the planet? Yeah, our species got the last laugh. And one of the ways we did this was through the development of a biological turbo-charging system that can -- for a short time -- make us more than we usually are. We developed the biological ability to increase our strength and speed in emergencies. When confronted with danger, our bodies pump out a powerful mix of hormones and sugar that increases strength to fight with, or speed to flee with. Hence the name fight-or-flight.

This sugar caused no great harm to our ancestors. It was quickly used up in the ensuing fight. Or flight.

This biological turbo-charger worked great for paleo people. And it probably even worked great for people in the middle ages. And it still does work for modern soldiers, or hikers in the woods who encounter lions, tigers, or bears. But there’s a problem. The body can’t differentiate between danger and stress. Both trigger fight-or-flight. 

So today’s most common “danger” isn’t the wild animals. It’s the letter from the IRS. There’s no quick resolution. No violent fight, no urgent flight to burn off the sugar. Instead, we sit in a heap, our bodies surging with sugar, with no resolution, and no way to burn it off.

That’s how stress messes with diabetes. Acute stress floods us with unwanted (and un-medicated) sugar. Chronic stress is like a leaking faucet, constantly dripping extra sugar into our systems. The impact on blood sugar caused by stress is so significant that some researchers feel that stress serves as a trigger for diabetes in people already predisposed to developing it.

As they say on late night TV: But wait, there’s more. Beyond the pure physical impact of stress, there’s also a mental element: If you are stressed out, your mental bandwidth to deal with complex tasks is reduced. That impacts complex tasks, like, say, diabetes control. When people get stressed out they’re more likely to eat comfort foods, to skip difficult tasks or medications, and to basically ignore their diabetes. This is even more significant when it comes to stress’s first cousin: Depression.

Depression’s negative effect on diabetes control is well documented, and deadly serious.

OK. So what to do about stress? How can you reduce it so that it has less of an effect on your blood sugar control? Well, that depends on the nature of your stress. Anything in life that is stressing you out that’s “fixable,” you should fix. That stupid toilet that runs all night and disturbs your sleep? Fix it. That’s easy. Sometimes it’s harder: The boyfriend who always puts you down? Dump him. Not all that easy to do, but it will improve your health. Meanwhile, things that stress you out that you can’t fix, that you can avoid, you should avoid. Your sister drives you nuts? You’re not required to visit her, you know.

Lastly, of course, there are things in life that you can’t fix and you can’t avoid, and these you need to develop ways to deal with. Sometimes this involves changing your metal attitude toward it; other times it’s the use of stress-relief tools, like exercise to burn off that fight or flight sugar, or hot baths and aroma therapy candles to drown the stress so that your body stops releasing the sugar.

Now, all of this is not to say that the meds you’re taking aren’t playing a role in your ups and downs, too. If your medications are poorly matched to your food intake, they can absolutely be the cause of glucose highs and lows. But don’t discount the very real impact that stress has on our bodies, and our diabetes. As I said, stress is sugar. Literally. And it needs to be respected by people with diabetes just like any other sugar. Its impact needs to be recognized, acknowledged, and dealt with—especially as we’ve entered into a new era of record stress and stressors.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences. We are not MDs, RNs, NPs, PAs, CDEs (or partridges in pear trees). You still need the professional advice and care of a licensed medical professional.