We are in November, National Diabetes Awareness Month. Do you or a loved one have diabetes? If so, you know that this is a disorder that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of diabetes. Also, you likely know that your body doesn't use insulin properly. Over time, your pancreas can't keep up making the extra insulin needed to process the high levels of glucose. The prevalence, or number of people with the disorder, was 29.1 million Americans in 2012, or 9.3% of the population. The incidence of diabetes is increasing and this clearly is a major medical problem across our country. Medical complications can include stroke, heart disease, kidney problems, foot ulcers, blindness, and peripheral neuropathy (lessened sensation in the feet), among others.
If you have type 2 diabetes, you know that certain foods — particularly foods that are high in carbohydrates — can greatly elevate your blood glucose (sugar) levels. However, you likely are less aware that there are numerous stress related factors, e.g. chronic work and relationship problems, reduced sleep, chronic illness, that can interfere with the ability to maintain proper blood sugar levels. According to the American Diabetes Association (ADA), emotional stress can cause blood sugar to elevate significantly. As blood sugar control is the key to successful management of Type 2 diabetes, it’s worth knowing how stress affects you and to find coping strategies to deal with your stressors.
So how does stress affect your blood sugar level? When you are under stress, stress hormones like epinephrine and cortisol are activated since one of their major functions is to raise blood sugar to help boost energy when it's needed most. Think of the fight-or-flight response. If you are confronted with a life threatening danger, you need your blood sugar level higher to handle the danger. If you are not diabetic, you have compensatory mechanisms to keep blood sugar from getting out of control. However, if you are diabetic you don't have enough insulin to keep the blood sugar at a proper level. Over time, you become at risk for the negative medical outcomes noted above. Emotionally upsetting events like relationship breakups or significant work difficulties place physical stress on your body. If you have diabetes, you are at risk to have elevated blood sugar levels. It even has been shown that some "happy" events can be stressing enough in a positive sense to effect the same problematic elevations of blood sugar levels.
It's possible to make the problem worse because, when under stress, you may sleep less, exercise less, and eat less well. You may eat unhealthfully, i.e. junk food or comfort food like candy or chips. Since exercise helps to lower blood sugar, reducing this activity under stress can make the problem worse. We discuss all aspects of the relationship between stress and diabetes in our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. You can learn more about the authors, book, and stress by visiting our website at www.manageyourhealthandstress.com.
But for now, what can you do to reduce your level of stress in the service of managing your diabetes? One of the major strategies on which most experts agree is to help yourself become more aware of your stress level and how you feel when you are under stress. Often we fail to recognize the daily stressors such as busy times at work or holiday activities which may alter the blood sugar level. If you can begin to record stress levels and events at the time you take blood sugar levels, you soon will establish a helpful level of self-monitoring. You will be more aware of your stressors and take some action as well as recognize the need to adjust your medication if you are taking it.
Here are a few other stress reducing strategies to help you better manage your diabetic condition:
1. Initiate relaxation procedures. You can try yoga, meditation, mindfulness, deep breathing, or progressive muscle relaxation (PMR), about which I've written in other posts. My favorite is PMR, in which you practice tensing and relaxing major muscle groups in sequence while combining pleasant visual imagery and proper breathing. In fact, a study published in the journal Diabetes Care showed that just five weekly sessions of a relaxation therapy can reduce blood sugar levels significantly.
2. Learn cognitive behavior therapy (CBT). In addition to learning to relax, CBT assists you in evaluating your problematic, catastrophizing, and often overgeneralized thoughts leading you to feel tense, frustrated, and upset. You can learn to react differently to the challenging events in your life through re-evaluating your thoughts and thus your emotions. As I always say, "Change your thoughts and change your results".
3. Use your social support network. Talk to a trusted friend or confidante about your concerns. Talking about problems can help lessen the stress associated with them. Don't have a social support network? Maybe this is a good time to develop one, you might see my posts on this topic as well. If nothing is working, consider talking with a mental health professional.
4. Maintain healthy eating, sleep, and exercise routines. As mentioned earlier, exercise can help lower blood sugar, so a stressful phase is not the time to stop your program.
5. Develop relaxing routines, such as starting a hobby, taking walks, or joining a class you like.
6. If the above still is not working, know that there are antianxiety medications available which may help. See your medical care provider.
Diabetes is a serious medical condition. Managing your emotional stressors is a key part of keeping the condition in check. Your reaction to the stressors of life is a choice. Make it a healthy one.
Good luck on your journey.
Dr. Paul Longobardi
For more information on these and related topics, please visit my website at www.successandmindset.com