Mental and physical stress can raise blood sugar levels. You may need to treat this hyperglycemia with insulin or other diabetes drugs.

Most people with diabetes are aware that eating most foods will cause blood sugar levels to rise in the body, much like taking insulin will bring blood sugar levels back down.

That process is normal and also happens internally in people without diabetes. The key difference is that people with diabetes must do all the external management of the pancreas.

But other things can cause higher blood sugar, as well. Stress is one of those. The World Health Organization has labeled stress as one of the most significant health problems of the 21st century and that it is a growing problem — as is diabetes.

This article will look at how stress impacts blood sugar, why it can cause hyperglycemia, and what you can do to address it.

When you eat carbohydrates or anything with sugar, it causes an almost immediate blood sugar spike.

However, stress on the body — whether physical, emotional, or mental — can raise blood sugar levels gradually and cause persistent hyperglycemia as well.

Chronic stress can cause insulin resistance, which also makes blood sugar levels harder to control, resulting in hyperglycemia.

How stress impacts your blood sugar

Stress in the form of an infection, serious illness or injury, or emotional stress, alerts the body to release certain hormones that inevitably impact blood sugar levels.

When stressed, the body enters into a “fight or flight” zone, where it must ensure that it has enough energy. In turn, insulin levels fall and glucagon, cortisol, and adrenaline are released in your body, as well as more glucose from the liver to fuel the body.

In people without diabetes, this may feel like an energy surge. But in someone with diabetes, it can result in higher blood sugar levels, lethargy, and an energy crash.

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Stress hyperglycemia, which is measured as a blood sugar level over 180 mg/dL, may occur due to the inflammation from an illness or infection that leads to insulin resistance and decreased insulin secretion.

Additionally, during an emotional or psychologically stressful event, the release of hormones including epinephrine and cortisol floods the body, along with the liver dumping extra glucagon into the bloodstream.

Combined, these hormones and sugars spike blood sugar levels and can lead to lasting insulin resistance.

This is a common occurrence in the hospital setting when patients are admitted to the intensive care unit (ICU), with at least half of people experiencing blood sugar over 180 mg/dL in the first 48 hours after admission.

These high blood sugar levels contribute to increased morbidity and mortality, and strict blood sugar monitoring and insulin administration are key.

Even in people without diabetes, such high blood sugar levels in a hospital setting may require insulin injections until insulin resistance returns to normal.

Outside of a hospital setting, people without diabetes can also experience bouts of increased blood sugar levels and insulin resistance, especially during difficult and stressful times and also during illnesses, injuries, and infections.

For most people outside of a hospital setting, the blood sugar spikes are not severe enough to warrant injected insulin treatments.

However, experiencing prolonged stress-induced hyperglycemia can increase your risk of eventually developing type 2 diabetes.

Poor glycemic regulation can closely mirror mental health symptoms, such as irritability, anxiety, and worry.

In a hospital setting, doctors will closely monitor bodily signs of stress in order to manage symptoms. In people with stress hyperglycemia, this can help prevent further complications and death.

Other signs of systemic stress hyperglycemia include:

  • having trouble getting to or staying asleep
  • having digestive problems
  • feeling moody or sad
  • feeling angry or irritable
  • experiencing frequent headaches
  • using substances, like tobacco and alcohol, more than usual
  • having low energy
  • getting sick more than usual

In a hospital setting, you will most likely be treated with an intravenous insulin drip to bring blood sugar levels back down to a normal range.

This is especially true if you’re having surgery or are experiencing an infection, as high blood sugar levels increase inflammation and make wound healing and fighting off infections more difficult.

Outside of the hospital setting, stress-induced hyperglycemia will rarely require insulin injections.

The key is to target and manage the underlying stress: whether that means treating an infection with antibiotics, recovering from a bout of illness, or decreasing your emotional, mental, and psychological stress.

Doing so will decrease inflammation and the release of the “fight or flight” hormones and will lower blood sugar levels naturally.

You can help manage stress by doing the following:

  • participating in regular exercise and staying physically active
  • eating a healthy, balanced diet of whole foods with little to no added sugar
  • doing deep breathing, yoga, and meditation activities
  • getting 7–9 hours of sleep per night
  • limiting alcohol, tobacco, and caffeine intake
  • seeking social and community support

Stress on the body, whether physical or mental, affects blood sugar levels in people both with and without diabetes. This is caused by underlying illness, infection, injury, or an immensely emotional time.

When the body is flooded with inflammation, “fight or flight” hormones, such as cortisol and epinephrine, and the liver dumps glucagon into the bloodstream. Insulin resistance and the resulting hyperglycemia can be the result.

For people with diabetes and those without diabetes but who are in the hospital, this usually requires insulin treatment, but for those outside of the hospital without diabetes, by addressing the underlying causes of the hyperglycemia, blood sugar levels return to normal in due time.