3. Diabetes and Stress

What is stress, and how does it affect blood glucose levels in someone with type 2 diabetes?

What is stress? Stress is a physiological response to a perceived attack or an event that produces strain. It can be triggered by a physical cause, such as injury, illness, or surgery. Or it can stem from an emotional reaction to problems with health, finances, or relationships. Stress can be "good" (an active vacation or a much-anticipated family visit) or "bad" (sickness, money woes, a family visit that turns contentious). It can be short term (getting stuck in traffic or catching a cold) or long term (dealing with diabetes or coping with an ailing partner).

• Stress takes a toll on the body. When the body feels stressed, it responds by triggering the fight-or-flight response, in which levels of certain hormones, such as adrenaline, cortisol, and epinephrine, kick in and shoot up. These stress hormones make a lot of stored energy -- specifically glucose and fat -- available to the cells to help the body escape from danger or get ready to do battle.

Everyone experiences stress from time to time. But having many stressors or a long, intense, physical response to stress can lead to health problems such as headaches, migraines, digestive troubles, insomnia, anxiety, and depression, as well as changes in appetite and cravings for caffeine, alcohol, and sugar.
How does stress affect people with type 2 diabetes? In people who have diabetes, the fight-or-flight response doesn't work so well. Insulin isn't always available to unlock cells and let that extra energy in, so glucose starts to back up in the blood. In addition, if someone with diabetes is dealing with an emotional stressor, his body may continue to pump out hormones with no end in sight, as neither fighting nor fleeing helps in a situation where the enemy is actually the mind.

• Stress elevates glucose levels. If someone you're caring for is experiencing stress, his blood glucose levels are likely to be elevated for a couple of reasons. First, stress hormones can make blood sugar levels soar, sometimes to harmful heights. Second, people under stress often don't take good care of themselves. He may forget to eat or exercise, skip medications, become dehydrated, or feel too under siege to check blood sugar regularly or keep routine medical appointments.

Chronic, long-term stress can be particularly taxing on the body and can increase his risk of routine stress-related health ailments as well as complications linked to diabetes.