Sugar Matters
March 3, 2015
Stress and diabetes – what to do, what to do?

Many people say it, and yes, it is true — stress makes your diabetes more difficult to control. There are a few reasons probably. One of the big blame points is on the higher production of cortisol — otherwise known as a “stress hormone.” We all produce amounts of cortisol every day, and in fact it is necessary for life. When you get stressed, your body makes more cortisol.The problem is that cortisol can raise blood sugars higher, and if you have diabetes this means it may make your sugars get MUCH higher.{{more}}

Another reason is that eating patterns can change when people are stressed. They tend to eat more “comfort foods” that are richer in carbohydrates (starches) and sweets, which, of course, make your sugars higher. Raise your hand if you like some tea and cake after a bad day. How about two beers instead of one? Yes, you, raise your hand!

The third reason is one that folks do not notice sometimes — medication patterns also tend to change. Perhaps you take it at a different time, or forget altogether in the midst of all this worry. Of course, this also does some damage and sugars get out the gate. By the way, what counts as stress? This is definitely subjective; what is stressful to one person may not be for another person. My broad way of looking at this is that “a stress” is any event that causes a change from your normal pattern of life and feeling of well-being.

It can be for something welcomed – like a job interview or getting married; or it can be something unwelcome – like a car accident or someone dying in your family. It can be physical or emotional. The big question I get is about treating high blood sugars that happen during stress. This also tends to happen with high blood pressure, by the way, which goes up during stressful periods. The answer is the same for both: if it is too high, it needs to be treated.

Why? Because no matter the cause, the fact that your sugars are high means that they have a chance to do some damage. Waiting for them to return to normal, especially if they are VERY high, only lets the damage go on for longer. I take care of patients in the hospital who have normal blood sugars when they come in, but they increase after surgery. We treat them with insulin in the hospital. When they go home, most of them do not need it because their sugars are back to normal. Why chase down those sugars during the hospital stay when I know that most likely they won’t need it when they return home?

We have lots of research telling us that people who run high blood sugars in the hospital have a high risk of getting surgical infections, staying longer in the hospital, and possibly dying. Who wants to sign up for THAT kind of risk? If your blood sugars tend to shoot up when you are stressed, you need to do two things: plan on changing your medications around to accommodate that rise, and try to identify ways to reduce your stress so this won’t happen as much.

DO NOT ignore very high blood sugars thinking, “Well, it is just from the stress; it comes back down eventually.” While you wait for the decrease, diabetes is busy damaging your body. Don’t give it that chance. Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227