Is Stress The Source Of Your Blood Sugar Swing
Right now, COVID-19 stress can feel like a given and if something causes you stress, it can also trigger an increase if your blood sugar level.
If you have type 2 diabetes, you know that certain foods particularly foods that are high in carbohydrates can send your blood glucose level through the roof. But did you know that theres a long list of other factors, such as too little sleep, illness, even monthly menstrual cycles, that can sabotage your best efforts to stabilize your blood sugar?
High on that list, though you may not be aware of it, is stress.
Whether its related to work, to relationships, or to some other aspect of your life, research has continually shown that emotional stress can cause blood sugar to surge, according to the American Diabetes Association . And because consistent management of blood sugar is the key to living a healthy life with type 2 diabetes, its important to understand how stress affects you and to find healthy ways to cope when mental distress mounts.
Thats especially true right now when the novel coronavirus is top of mind and everyones stress level is sky-high. In addition to heightening health worries, the COVID-19 pandemic comes with immense economic and daily living stressors. Whether youve lost your job, are working from home, helping your kids with e-learning, or quarantined by yourself, its natural to feel stress.
As if stress werent bad enough on its own, it can contribute to irregular blood-sugar levels.
Not Eating Enough Carbohydrates
Carbohydrates are a type of nutrient found in foods like grains, starchy vegetables, fruit, and some dairy products. Carbohydrates turn into blood sugar when digested, so they significantly impact blood glucose levels than proteins and fats.
Not eating enough carbohydrates, especially while also taking blood sugar-lowering medications, can cause hypoglycemia.
How Does Adrenaline Affect Your Blood Sugar
In a non-diabetic body, that surge of adrenaline triggering a surge of glycogen would be accompanied by a surge of insulin, too.
As people with diabetes, were missing the surge of insulin part, which can easily spike your blood sugar from 120 mg/dL to 300 mg/dL in less than an hour.
Adjusting your insulin for this can be tricky. A quick bolus of insulin using your normal correction factor ratio could easily produce little or no effect on the high blood sugar while adrenaline is present.
Personally, Ive found that I needed a significant increase in my background insulin doses on the day of a powerlifting competition in order to keep my blood sugar from spiking due to adrenaline. A quick bolus would have no impact and the only thing that would otherwise bring my blood sugar down was when the competition ended and my body relaxed.
If youre dealing with predictable adrenaline around a sporting event, for example, talk to your healthcare team about making an adjustment in your background insulin.
If youre dealing with sudden, unexpected surges of adrenaline because you just got into a car accident, for example, youll likely have to try lowering it with a bolus of insulin but may not see it come down for a few hours.
When its actually not adrenaline
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Anxiety Over Diabetes Management
Managing your blood sugar and other aspects of your health when you have diabetes can be time consuming and stressful, and also contribute to anxiety.
For people with diabetes, monitoring blood sugar usually involves a home finger prick test. Fear of needles, as well as fear of the results, may lead to anxiety.
One study found that 33% of people with diabetes experience anxiety specific to the finger prick method of glucose testing. Thirty percent of people with diabetes in this same study had generalized anxiety related to their diabetes management.
Other areas of diabetes management may also lead to stress and anxiety. This includes monitoring potential symptoms of vision loss , nerve damage , slow-healing wounds on the feet or extremities, kidney damage, and more.
How Does Cortisol Affect Your Blood Sugar
Not only can cortisol contribute to unwanted high blood sugars, but its also essential for treating low blood sugars, too. Lets take a look.
When cortisol levels are high
When cortisol production increases beyond a healthy baseline, it blunts your bodys sensitivity to insulin. This means you need more insulin during those hours in order to keep your blood sugar in your goal range.
While your body does produce cortisol 24 hours a day, there are certain times of day anyone can expect to be producing more, like first the thing in the morning.
If you manage your diabetes with insulin, this also explains why you may notice that you need more insulin in the earliest hours of the day, and with breakfast.
As soon as you wake up in the morning, your body produces a surge of cortisol, explains the Society for Endocrinology. This surge is critical for simply starting your day and functioning fully now that you are awake!
And if your overall baseline cortisol needs increase due to constant, ongoing stress, youll notice that your baseline insulin needs increase, too.
You can read the post How to Avoid High Morning Blood Sugars for more information and practical tips for dealing with morning highs.
When cortisol levels are low
On the flip side, without enough or any cortisol you would struggle with constant hypoglycemia .
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Practice Mindfulness To Promote A Feeling Of Calm
Whether you choose deep-breathing exercises, meditation, or yoga, mindfulness techniques are designed to help you reduce stress.
A short-term randomized controlled trial of 60 people with type 2 diabetes found that those who used mindfulness-based stress reduction techniques saw improved fasting blood sugar and A1C and lower levels of anxiety and depression. Researchers published those results in 2018 in the Journal of Diabetes Research.
Explore a variety of relaxation techniques, Belfort De Aguiar suggests, to find one that works for you. If you have trouble winding down, apps such as Headspace and Calm are popular, budget-friendly options for learning how to practice mindfulness.
Three Sneaky Reasons Your A1c Levels Fluctuate
When youve lived with type 2 diabetes for a while, you become a pro at managing your glucose levels. You know that its best to limit carbs, exercise regularly, check other medications for possible interactions, and avoid drinking alcohol on an empty stomach.
Sometimes, things you may not even think about can affect your blood glucose, which can in turn lead to serious complications, such as heart attacks, kidney disease, blindness, or amputation. Learning to recognize behaviors and circumstances that you dont normally associate with blood glucose fluctuations may help you prevent more serious problems now and in the future.
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Other Ways Stress Causes High Blood Sugar
There are other ways that stress can lead to spikes in blood sugar. During periods of stress, people may participate in behaviors that could lead to high blood sugar such as emotional overeating of refined carbohydrates or foods that are high in added sugars. People may also fail to exercise or take their medications when theyre supposed to. Since stress has the ability to change healthy habits, these factors can all lead to elevated blood sugar levels.
Stress can also affect sleep because stress and sleep are both controlled by the hypothalamus-pituitary-adrenal axis. When a person is under high stress and the axis is encouraging the extra production of cortisol, changes in the axis occur. This leads to problems with getting quality sleep as well as changes in sleeping patterns. When a person isnt getting enough sleep, it can cause glucose intolerance, which describes metabolic conditions that cause high blood sugar levels.
Low Blood Sugar Mimics Anxiety
The mutual symptoms of low blood sugar and anxiety are not coincidental. There is a shared physiological base of the two conditions.
When low blood sugar occurs, the body attempts to normalize levels by bringing blood glucose up. It does this through epinephrine excretion, which triggers glucose production in the liver.
Increased adrenaline levels, however, trigger a “fight or flight” response in the body. This same biochemical process is also linked to anxiety.
A longer-term or chronic low blood sugar state can also cause the body to produce cortisol, which is the “stress hormone.” Cortisol helps tissues in the body be less reactive to insulin, which helps increase glucose circulation in the bloodstream.
While this may help raise and normalize blood sugar levels, higher cortisol levels are also linked to anxiety. For this reason, many of the warning signs and symptoms of low blood sugar are shared with that of anxiety.
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Triggers Could Be Tricky
Life changing situations or a big situation are obvious triggers of stress. Stress can be more difficult to identify if the cause is a buildup of many smaller events. Having too much going on does not mean you are stressed. On the contrary, not having enough work, activities or change in your life are all factors that may cause stress. Constantly worrying or feeling that you do not have control over a situation can also cause stress3.
Preventing Low Blood Sugar
For someone with diabetes, the best way to prevent low blood sugar is to check your blood sugar often. You can check your blood sugar with a continuous glucose monitor or glucometer. Discuss with your healthcare provider how often you should be checking your blood sugar.
Your healthcare provider might suggest checking before and after meals, before and after exercising, when changing your routine or schedule, when traveling across time zones, and more. By checking your blood sugar, you can identify when your sugar is falling and enact steps to normalize your levels.
For people both with and without diabetes, another tried-and-true way to prevent low blood sugar is to eat regular meals. Avoid skipping meals or fasting. When you do eat, research indicates that eating a diet low in refined carbohydrates, and inclusive of omega-3 fats and adequate protein, can help regulate blood sugar and lower anxiety levels.
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Follow These Steps To Find Out If Your Blood Sugar Levels Are Affected By Mental Stress:
Can Stress Cause Your Blood Sugar To Be High
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The Wrong Way To Deal With Stress When You Have Diabetes
Food, alcohol, self-pity: These unhealthy coping mechanisms do more harm than good. When were stressed out, we turn to unhealthy food comfort food and we may start eating a lot of sweets, Belfort De Aguiar says. These are the wrong ways to cope with stress.
Also, find ways to reach out and find social connection with your loved ones. Campbell also warns against keeping your emotions bottled up inside. Be sure to share your stress, she says, even it just means having someone listen to you vent.
For more on dealing with diabetes burnout, check out Diabetes Daily’s article “How to Get Out of a Diabetes Rut“!
Can Stress Affect My Blood Sugar Levels
There are several ways that stress may affect your blood sugar levels. Stress induces the well-known fight-or-flight response, in which your body increases its levels of certain stress hormones. These, in turn, cause a rise in the amount of sugar in your blood, where it’s available to be used by your cells as fuel. If your body doesn’t have enough insulin or can’t use the insulin it has in order to get that blood sugar into your cells, your blood sugar levels remain high. Stress may also indirectly increase your blood sugar levels by causing you to abandon your good habits. When stressed, you may not eat well or exercise regularly, or you may drink more alcohol. These habits can cause your blood sugar levels to rise. In addition, you may not take time to check your blood glucose levels as often when you are stressed, so you may not be aware of the effects that the stress is having on your blood sugar levels. If you feel that stress is affecting your diabetes, talk to your doctor.
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Hypoglycemia And Adrenal Fatigue
You may not realize it, but becoming severely stressed can trigger adrenal fatigue, which can lead to hypoglycemia. This is because several adrenal hormones including cortisol, epinephrine, and norepinephrine play critical roles in the regulation of your bodys blood sugar levels. In fact, epinephrine plays a role in the short-term control of your bodys blood glucose. Epinephrine is involved in the increase of blood sugar when the body encounters stress. Meanwhile, cortisol is involved in the long-term maintenance of your bodys blood glucose levels.
When the body experiences stress, the adrenal glands prepare it for a fight or flight response by releasing the primary stress hormone cortisol. As cortisol levels rise in the body, both fat and muscle in the body become less sensitive to insulin. Because of this, more glucose becomes readily available in the bloodstream.
This activity is all part of the bodys entire NeuroEndoMetabolic Stress Response system. It is made up of the response from several organs and systems in the body, including the heart, liver, hormones, immune system, and the adrenal glands. Using the hormone cortisol, the adrenal glands help ensure that the body has enough energy to deal with the stress at hand.
When this happens, the cells fail to receive the glucose and other nutrients that they need to stay healthy. You may find yourself craving sugar while feeling shaky, tired, and even weak.
Too Much Insulin Or Diabetes Medications
Many people take diabetes medications to manage their blood sugar levels. Out of all the available diabetes medicines, injectable insulin carries the greatest risk of low blood sugar, especially rapid-acting insulin.
Because insulin lowers blood sugar, taking too much insulin or other diabetes medications can cause hypoglycemia.
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The Mental Vicious Circle
Beyond the pure physical impact of stress, theres a confounding mental element: If you are stressed out, your mental bandwidth to deal with complex tasks is reduced. You are less organized, energetic and motivated. So naturally, this impacts diabetes control. When people get stressed out, theyre more likely to eat heavy comfort foods, skip difficult tasks or medications, and to basically ignore their diabetes. This is even more significant when it comes to stresss first cousin: Depression.
Depressions negative effect on diabetes control is well-documented, and deadly serious.
Theres a big difference between being stressed or burnt out, and being clinically depressed, according to Dr. Bill Polonsky, founder of the Behavioral Diabetes Institute, in this article on mental health and diabetes.
Depression is a clinically diagnosed or diagnosable medical condition, whereas experiencing stress is not. He explains:
Still, everyday stress on its own can certainly derail your diabetes management, and research shows it can even weaken your immune system.
Fill Your Doctor In On Big Life Changes
If a stressful situation is causing your blood sugar to swing, your healthcare team needs to know. Says Campbell, Your doctor may temporarily change your diabetes medication or put you on a higher dose. If necessary, he or she can even make a referral to a mental health professional. Right now, increasingly more primary care physicians, psychologists, and other healthcare professionals are offering telehealth services so that you can get the help you need while maintaining social distancing practices.
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How Does Adrenal Fatigue Cause Low Blood Glucose Levels
During times of chronic stress, the adrenal glands respond by releasing cortisol. This hormone is also linked to the release of more glucose into the bloodstream. At some point, however, the adrenals become exhausted and they are no longer able to produce enough cortisol, leading to low blood glucose levels.