It's a Catch-22: Diabetes gets you stressed out and the stress worsens your diabetes.
Do you sometimes feel like your entire life is centered on your diabetes? When you’re snacking, you’re thinking about your blood sugar level. When you’re exercising, you’re nervous to work your body too hard. When you’re at work, you make sure you have a snack on you at all time or extra insulin shots. When you’re at home, your spouse and children try to not eat their favorite sweets around you.The stress of constantly thinking about diabetes can take a toll on your body. We know that stress is not just bad for our mental health, but also bad for our physical health. This includes your diabetes and its often undiagnosed companion, hypertension. It’s not bad to be a little more conscious or concerned about your health—but high stress levels can negatively impact your body and potentially worsen your condition.
High stress can worsen your diabetes in 5 different ways:
1. Stress raises blood sugar levels
Why does extra tension in your body cause your blood sugar to go up even if you haven’t eaten anything? There are a number of factors that go into this, but a primary reason is that stress triggers the body to release cortisol, which is a hormone that helps the body get through tough situations (the fight-or-flight situations).When cortisol comes out to play, your heart rate and breathing speed up. This also sends glucose and protein stores from your liver into the blood to make energy immediately available to your muscles. In other words, your body releases sugar into the blood so that the energy can get throughout your system. The result: higher blood sugar levels.
2. Stress activates our fat cells
That isn’t the end of the story for cortisol. Cortisol also triggers an enzyme in our fat cells that helps relocate fat from storage deposits around the body to fat cell deposits deep in the abdomen, also known as visceral fat cells. Stress can actually cause many people to accumulate more belly fat. The more stress you have, the more cortisol is in your body and the more abdominal fat you’ll find.In studies, these central fat cells have been linked to not only a greater risk for heart disease, but also a higher risk for diabetes. If you already have diabetes, your condition can grow worse because of an overall elevated level of stress and cortisol in your system.Not only that, but cortisol also increases food cravings, which are already hard to manage with diabetes.
Stress-induced cortisol increases food cravings, making it even harder to manage your diet[/caption]But it's ok to snack! If you haven't had a chance to see it, we've posted a blog on 5 "Swap" Food that Decrease Stress. Just remember, everything in moderation.
3. Stress contributes to insulin resistance
Cortisol also makes it more difficult for the pancreas to secrete insulin, which is needed to move sugar out of the blood and into the cells for energy, stabilizing the concentration of sugar within your blood. Over time, the pancreas struggles to keep up with the high demand for insulin. Glucose levels in the blood remain high. Cells cannot get the sugar they need and the cycle continues.This all contributes to insulin resistance—which you’re already fighting against—and may worsen your condition
4. Stress impacts sleep, which impairs glucose tolerance
Often times, stress leaves us tense and anxious and can cause sleep problem. Many studies have shown the negative health impacts of not getting enough sleep. The impact on diabetes is no exception.
Although everyone has their own standards of what good sleep is, keep in mind that sleeping less than six hours a night has also been found to contribute to impaired glucose (or sugar) tolerance, a condition that often precedes or can worsen the progress of type 2 diabetes.Add to this, the fact people who are tired tend to eat more because they want to get energy from somewhere. This is usually by consuming sugar or other foods that can spike blood sugar levels, further aggravating their diabetes.
5. Stress affects your blood pressure
Let’s go back to the hormone cortisol for a moment. Another one of cortisol’s functions is to narrow the arteries throughout the body in order to allow blood to pump harder and faster through the rest of the body. In fight-or-flight situations, this is advantageous because delivery of oxygenated blood throughout the body.However, constant stress over time keeps the blood vessels constricted and keeps your blood pressure high. Over time this high blood pressure (or hypertension) can worsen many of the complications of diabetes, including diabetic eye disease and kidney disease. In fact, many people with diabetes eventually develop high blood pressure.It is no wonder that diabetes and hypertension often go hand-in-hand. Looking out for one can help prevent or alleviate the other.
A quick and simple step to help better your health
One simple way to ensure yourself that you’re not causing more harm to yourself by being concerned about your health as diabetic is to check your blood pressure regularly.When you keep track of your blood pressure (iOS, Android), you’re empowered with the knowledge to know what works best for your body.For example, if you’re a bit more stressed than usual, you’ll be able to see that trend. If a particular meal and diet plan is not working for you, you’ll be able to observe that in the numbers that your measurements present. If an exercise routine is a bit more intense than your body can handle, your blood pressure measurements can show you that.Getting a simple home blood pressure monitor and then tracking your blood pressure on an app, like Hello Heart (iOS, Android), is a way to good way to start. The Hello Heart app is free in the iTunes store and Google Play. It included built-in reminders and colorful visuals that help you easier see the trends that matter the most.
The Hello Heart App keeps track of your blood pressure and heart health trends. Available for iPhone and Apple Watch.[/caption]But of course, don’t feel guilty for being stressed. Stress is a completely normal reaction to dealing with tough things in your life. But even just a little bit more awareness about how stress affects your health can help you manage your diabetes beyond what the doctors have recommended you and help you regain your control of your own life. Just remember that your life is not dictated by your diabetes.You control your diabetes, and ultimately you are the one in charge of your life.
1. Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/jamanetworkopen.2021.27008. Accessed October 19, 2022. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication. This study showed that 108 participants with baseline blood pressure over 140/90 who had been enrolled in the program for 3 years and had application activity during weeks 148-163 were able to reduce their blood pressure by 21 mmHg using the Hello Heart program.) (2) Livongo Health, Inc. Form S-1 Registration Statement. https:/www.sec.gov/Archives/edgar/data/1639225/000119312519185159/d731249ds1.htm. Published June 28, 2019. Accessed October 19, 2022. (In a pilot study that lasted six weeks, individuals starting with a blood pressure of greater than 140/90 mmHg, on average, had a 10 mmHG reduction.) NOTE: This comparison is not based on a head-to-head study, and the difference in results may be due in part to different study protocols.
2. Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021- Final.pdf. Published October 2021. Accessed October 19, 2022. (This analysis was commissioned by Hello Heart, which provided a summary report of self-fundedemployer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)
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