Diabetes and stress

This is a question that comes up very frequently in clinic, and also in normal conversations:

Can stress make your blood sugars go up?

The answer is the same as if you ask me if I love guava cheese-YES, but not all the time. Let me explain:

In general, stress can certainly cause blood sugars to become higher. Now, what I mean by stress is definitely up for debate, depending on whom you ask. Some people will say everyday life has nothing to do with this kind of stress, and insist it is only BIG stresses like surgery, deaths in the family, infections, etc. Other people would say that a stressful everyday life could do it for some people.{{more}} I have a patient whose adult daughter moved back into her house, but was using drugs, so she and her daughter fought all the time. Does that sound like a stressful situation? It does to me, so I was not surprised when she told me that her blood sugars would become higher after arguments with her daughter. Many patients in the hospital have blood sugars that are higher than usual because they are sick and their bodies are stressed from their illness.

Biologically, there is a source for this happening. Cortisol, known as the “stress hormone”, increases during periods of physical or psychological stress. One of the many effects cortisol has on the body is to increase the availability of glucose to the body. If you do not have diabetes or tendency towards diabetes, often your blood sugars still stay normal, even with that higher cortisol level. But for those with diabetes or a tendency to develop the disease, for whatever reason, this additional cortisol can push sugars noticeably higher.

Remember also that there are some other lifestyle factors that worsen blood sugars during stressful times. How many of you like to have extra sweeties, fudge, chocolate or ice cream when you have had a bad day? How many of you knock back an extra beer “to relax” after a tough day at work? How often do you skip exercise plans and relax in front of the TV because you need some time “to de-stress?” All of these actions also work to raise blood sugars, so if you notice that you tend to do any of these when feeling stressed, you will really need to reel yourself in and find other ways to deal with it.

How do we deal with this issue? For people having everyday stresses in life, the first thing to do is hopefully find ways to deal with the stress so it does not impact life as much. Easier said than done, true, but that is the best way. My patient ended up asking her daughter to leave the house, for many reasons, including the fact that she was becoming sicker under this situation. Other people seek out support in their church, family, with a counselor, increase their exercise, etc. When those options fail, or the situation is a BIG stress like surgery, we usually increase the dose of medication until the stressful period has passed. As always, if you notice this pattern is happening with you, contact your doctor to discuss it further.

Hope this answers your question! Until next week stay safe and healthy Vincies!

Anita Ramsetty, MD endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227