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Remain Calm: Stress Can Have Harmful Effects on People with Diabetes

Diabetes can be a stressful condition. That stress, however, can actually make things worse because it can lead to high blood glucose levels.

For people who don't have diabetes, their bodies can adjust to deal with the increase in blood sugar that goes along with our internal "fight or flight" instinct. But those with diabetes don't have the same internal fix-it kit to keep levels in order.

And the blood glucose increase can happen with mental stress, such as a tough day at work, a breakup, a death in the family, or physical stress, such as an illness or a car accident.

Researchers say that managing stress, and thereby controlling one's blood glucose levels, is vital for diabetics. Identifying stressors and learning to respond to them with techniques such as progressive muscle relaxation and breathing exercises has a profound impact on maintaining good blood glucose levels.

"The stress management techniques, when added to standard care, helped reduce glucose levels," said Richard Surwit, lead author of a study that appeared in Diabetes Care in 2002 and a medical psychologist at Duke University. "The change is nearly as large as you would expect to see from some diabetes-control drugs."

Those involved in the study also learned progressive muscle relaxation, mental imagery, and instructions on how to modify responses to stress. "Managing stress can significantly improve a patient's control of their diabetes," Surwit said.

Other techniques for controlling stress include:

• Taking part in a regular exercise routine, and sticking with it especially during stressful times.
• Participating in yoga or meditation classes.
• Talking to a therapist or counselor.
• Eating healthy foods and avoiding caffeine.
• Getting a massage.

Some side-effects of stress also can have an impact on diabetics. When people feel stressed out, they often don't take care of themselves like they normally would. They may deviate from their normal food schedule or exercise regime, or they may forget to check their glucose levels.

But at times like these, health experts say, it is especially important to maintain a healthy routine. Continuing to eat healthy foods in reasonable quantities, remaining physically active, and checking your glucose regularly while you are feeling stressed will do two things: prevent your blood glucose levels from getting worse because of poor food choices or lack of exercise, and help you return to a less-stressed state.

Beyond everyday stress, however, depression is common among diabetics. According to the National Institute of Mental Health, "the chances of becoming depressed increase as diabetes complications worsen." In people who have diabetes and depression, NIMH says, psychotherapy and antidepressant medications can have positive effects on both mood and blood sugar control. The agency recommends that people with both conditions seek help from their health care providers.

Adapted by Editorial Staff, February, 2005
Last update, July 2008