Stress And Diabetes Control

Do you ever feel like stress makes managing your diabetes even harder? You're not alone. There's a strong link between stress and blood sugar levels, and cortisol, the body's main stress hormone, plays a key role.

The reason? The stress hormone cortisol is linked to higher blood sugar levels, according to a study published in the journal Psychoneuroendocrinology.

Cortisol And Blood Sugars

Under stress, the body releases cortisol, which leads to an increase in blood sugar and a decrease in insulin (the hormone that helps process that sugar).

Cortisol is produced by the adrenal glands. The hormone affects nearly every organ and tissue in the body, and plays many important roles in daily function.

Among those roles, cortisol helps regulate blood sugar levels, metabolism, blood pressure and inflammation.

Hypercortisolism -- higher-than-normal levels of cortisol -- can cause weight gain, high blood pressure, muscle weakness and mood changes. All of these problems can further complicate diabetes management.

"This is all part of the fight-or-flight response. You need sugar if you want to run from, let's say, a bear. To prepare for that, your body needs to make energy, so it releases cortisol," explained endocrinologist and study author Dr. Joshua Joseph.

Cortisol levels naturally fluctuate. They're highest in the morning as you rise, and usually fall at night. But in people with diabetes, cortisol levels stayed steadier throughout the night, the team found.

The researchers noted that past studies have linked stress and depression to a steadier cortisol level.

The study included data from more than 2,000 participants, aged 45 to 84, who were followed over six years. The investigators found that people with diabetes who had steadier cortisol levels (indicating stress) tended also to have higher blood sugar (glucose) levels.

"Cortisol is driving glucose changes, and it does make diabetes much harder to control. Naturally, cortisol levels should be going lower in the evening. But people with stress have higher cortisol levels and blood sugar at night. Cortisol also makes you want to eat, and when you're stressed, you're not reaching for the carrots and broccoli -- you're reaching for high-carbohydrate, high-sugar foods," Dr. Joseph said.

Over time, higher blood sugar levels can lead to serious complications of diabetes, such as vision problems, heart disease and kidney disease.

Dr. Akankasha Goyal, an endocrinologist at NYU Langone Health, reviewed the new study findings. She described cortisol's impact of blood sugars as a "double whammy."

"It increases glucose production, and it decreases insulin from the pancreas," she said. "And, in patients with type 2 diabetes, at baseline, their bodies are unable to use insulin effectively and their glucose levels are higher."

Stress And Your Blood Sugars

Dr. Goyal said the study is proof of what many patients already knew: that stress can worsen blood sugar control. The findings may help motivate people to take steps to control their stress, she added.

"Stress relief is medication without side effects," she said. "Exercise if you can. Walk, yoga, tai chi or lift some dumbbells. Do mindful activities, paint, read a book -- anything that slows down and quiets the mind."