Stress and Blood Sugar Levels
We’ve all felt it before… you know, that feeling you get when you spill your coffee while you’re stuck in traffic, already late for work, and when you finally arrive you’ve got more tasks on your list than expected. Experiences like these typically only lead to one feeling – stress! It’s that familiar tightness in your stomach, the racing thoughts, and the overwhelming sense of pressure that seems to weigh you down.
But beyond the immediate emotional and psychological effects, there’s something else happening beneath the surface: your body’s physical response to stress, which can not only increase your blood pressure but also has significant implications for your blood sugar levels as well.
Today I’ll explore the fascinating dynamics between stress and blood sugar levels, uncovering the mechanisms behind stress-induced changes in blood sugar to, exploring the dynamic back-and-forth between them, and more importantly, sharing practical strategies for mitigating this connection to preserve our health.
I want to empower you with the knowledge and tools necessary to navigate this intricate terrain with more confidence.
Stress and Blood Sugar: A Vicious Cycle
When stress strikes, our bodies release a cascade of physiological responses designed to help us cope with perceived threats or challenges. Historically, these would have most commonly been fights or the need to hunt or flee. At the forefront of this response are two key stress hormones: cortisol and adrenaline. These hormones, often referred to as the body’s “fight or flight” messengers, mobilize resources to fuel our immediate response to stress. Cortisol, in particular, plays a central role in regulating blood sugar levels by promoting gluconeogenesis, the process by which the liver makes glucose from non-carbohydrate sources like amino acids and fats, and glycogenolysis, the breakdown of stored glycogen into glucose for energy. The energy provided by the liver creating glucose ensures that we can move quickly and have the energy for sustained battles.
As a result, when our stress hormones surge, so too can our blood sugar levels, providing us with the energy needed to tackle the perceived threat head-on. While this response can be beneficial in the short term, chronic or persistent stress can disrupt blood sugar regulation, resulting in many negative health impacts over time.
One such consequence is the development of insulin resistance, a condition in which cells become less responsive to the effects of insulin. Insulin is the storage hormone responsible for bringing glucose from the bloodstream into cells for energy. Over time, insulin resistance can lead to chronically elevated blood sugar levels as the cells become unable to take in additional glucose. This increases the risk of type 2 diabetes and other metabolic disorders. 2
What is the Impact of Blood Sugar Levels on the Stress Response?
So we see that stress influences blood sugar levels, but it’s essential to recognize that the relationship works both ways! Fluctuations in blood sugar levels can profoundly impact our mood and stress response, creating a feedback loop that further exacerbates our physiological and psychological reactions to stress!
One critical aspect to consider is hypoglycemia, a condition characterized by low blood sugar levels. When blood sugar levels drop too low, it can lead to a range of symptoms, such as irritability, anxiety, confusion, and even heart palpitations. These symptoms are a direct result of the brain’s reliance on glucose as its primary energy source. When glucose levels fall below a certain threshold, the brain struggles to function optimally, leading to emotional and cognitive disturbances.
Furthermore, unstable and erratic blood sugar levels, where there are frequent fluctuations between high and low levels throughout the day, can contribute to heightened stress reactivity. Research suggests that individuals with unstable blood sugar levels may experience greater emotional volatility and have a reduced ability to cope with stressors effectively. This phenomenon can be attributed to the body’s reliance on stable blood sugar levels to maintain optimal brain function and regulate mood. 3
In essence, the impact of blood sugar levels on the stress response is a two-way street. Just as stress can disrupt blood sugar regulation, fluctuations in blood sugar levels can intensify our physiological and psychological responses to stress.
Can You Actually Stress Your Way Into Diabetes?
Some research suggests dysregulated cortisol, particularly elevated evening cortisol, may increase the likelihood of glucose elevation and diabetes risk. Given the impact of long-term stress on cortisol levels, and cortisol’s impact on glucose and gluconeogenesis, this association is easy to see, but we don’t want to leap to conclusions.
While there is not yet very strong evidence supporting a direct link between stress levels and diabetes, there are studies among highly-stressed college students, workers with high ‘job strain’ and disaster relief workers suggesting an association that demands a closer look. (4-6)
One study done with 700 Thai college students showed that those who were at risk for type 2 Diabetes, based upon a risk assessment tool, concurrently reported higher degrees of psychological stress, higher pulse rate, and lower HRV status. Of the 700 participants, half had higher risk of diabetes and half did not. Within these groups, nearly 60% of those at risk reported high levels of stress. In the low risk group, slightly less than 14% reported high levels of stress. Further statistical analysis of this group revealed a 9 fold association between high stress and increased diabetes risk (9.32 OR).
An older 2014 analysis published in Diabetes Care looked at data from nearly 125,000 Europeans with self-reported ‘job strain’. This analysis showed a modest increase (HR = 1.15) in diabetes diagnosis among those with high job strain at a 10 year follow up. In this study, several variables such as physical activity, shift work, sex and socioeconomic status were taken into account to exclude factors which might muddy the waters, so to speak.
We can see between these two studies that high stress levels increase risk markers for diabetes, but the degree to which it actually leads to diabetes may not be extremely high. There are a lot of unknowns at play here regarding how it all pans out, and regardless of what research suggests about direct association, we cannot dismiss behavior changes under stress which may increase risk independently of the stress itself.
There are many factors downstream of stress, independent of glucose, which in and of themselves are strongly correlated with increased risk of developing diabetes. 7
If one responds to stress with increased alcohol consumption or emotional eating, this can predictably be problematic over time. Lack of sleep (possibly due to high cortisol) also disrupts glucose regulation, is itself a high stress upon the body and is strongly correlated with increased diabetes risk. Moderate to severe sleep apnea is an independent risk factor for diabetes as well as cardiovascular disease and must be considered as part of an overall metabolic health assessment. Additionally, some people do notice a strong correlation between stress and weight gain, and those with excess body fat are more often at higher risk than those with healthy levels of body fat.
Stress is also implicated in high blood pressure and inflammation, both of which can exacerbate diabetes risk. The research on all of this is, thus far, incomplete and with mixed results, so while we cannot definitively say “Stress increases your risk of developing Diabetes by X%”, it isn’t unreasonable to consider the role of stress in your life alongside your family and personal health history to make some decisions as to whether or not you feel this may be a personal risk factor for you.
The evidence is stronger that those with diabetes have a more difficult time controlling their glucose levels under high stress occasions, making stress management a crucial part of their overall care plan. I see this clinically as well – diabetic clients come back and report that stressful incidents or periods in their life have a definite impact on their blood sugar levels independent of what they are eating.
Strategies for Managing Stress and Blood Sugar Levels
It goes without saying that managing stress and maintaining stable blood sugar levels are essential components of overall health and well-being. Fortunately, there are a number of practical strategies that you can incorporate into your daily routines to achieve balance and resilience in the face of life’s challenges.
- Prioritize stress reduction techniques.
This can have a significant impact on both stress levels and blood sugar regulation. Mindfulness practices, such as meditation, deep breathing exercises, and progressive muscle relaxation, can help calm the mind and promote relaxation, thereby reducing the body’s stress response.
Additionally, regular physical activity has been shown to be an effective way to combat stress, as it releases endorphins and promotes a sense of well-being. Aim for at least 30 minutes of enjoyable movement most days of the week to reap the benefits for both your mind and body. Break this up into 3 ten minute breaks if you need to. Start with one bout of ten minutes and look for opportunities to increase wither the time of a single bout or add additional ones in.
Finally, don’t underestimate the power of adequate sleep in managing stress and blood sugar levels. Aim for seven to nine hours of quality sleep each night to support optimal physical and mental functioning. If you know you are not sleeping well, take steps to address sleep hygiene and get on a consistent schedule. If you sleep enough hours but consistently feel unrested, it may be worth getting a sleep study done to rule out apnea. These days there are even several in home and direct to consumer options you can look into.
- Carve out time for activities that bring you joy and connection.
I don’t know if it is the pervasive self-care memes on the internet over the last decade or what, but I often find suggestions to reduce stress to feel like another thing to put on the to-do list. Maybe it’s because usual suggestions like yoga and meditation do not work for me (even though they work so well for my husband) and, like flossing, feels like a chore to add into an already hectic day. I most often utilize stress reduction by sleeping, walking and running, but more gratifying than this, I schedule JOY and CONNECTION to include in my life rather than focusing on what will relax me.
Whether it’s spending time with loved ones, pursuing hobbies, or simply taking a leisurely walk outdoors, engaging in activities that nourish your soul can help counteract the effects of stress and promote overall well-being. Framing the addition of these stress-busting activities as ones which give you joy and satisfaction over what will ‘reduce stress’ might open up more possibilities than the generic suggestions found on the internet. If you struggle to make time for yourself, Remember that these means of self-care are not selfish but mandatory to maintain resilience and vitality in the face of life’s challenges. You want to be the one to choose when you recharge, not be forced to do so because your body makes the choice for you!
- Maintain a balanced diet.
It goes without saying that a balanced diet, while also paying attention to meal timing, can play a crucial role in regulating blood sugar levels. Focus on incorporating a variety of nutrient-dense foods into your diet, prioritizing protein and produce and adding in healthy fats and carbohydrates to your personal tolerance level.
Avoid skipping meals, as doing so can lead to dips in blood sugar levels and exacerbate feelings of stress and irritability. Instead, aim for consistent meals and snacks if needed throughout the day to keep blood sugar and energy levels steady. If your blood sugar tends to run high already, implementing a dietary plan to lower blood sugar is crucial. In the show notes you will find a link to blood sugar balancing breakfast and lunch ideas to get your day off to a good start. You can download those for free as a thank you for listening!
The Role of Social Support in Stress and Blood Sugar Management
Social support networks play a pivotal role in both stress management and blood sugar control, serving as a cornerstone of overall well-being. Numerous studies have highlighted the beneficial effects of social connections on reducing stress levels and improving blood sugar regulation. While dietary habits of Blue Zone communities are believed contributors to longevity, more current opinions are that the community and meaningfulness in elder’s lives are just as strong a predictor to longevity. When individuals feel supported and connected to others, they are better equipped to cope with life’s challenges and navigate stressful situations effectively. This emotional support can help buffer against the negative effects of stress hormones on blood sugar levels, promoting greater stability and balance.
Conversely, feelings of loneliness and social isolation have been associated with increased stress levels and poor blood sugar management. Without a strong support system in place, individuals may struggle to cope with stressors, leading to dysregulation of blood sugar levels and increased risk of metabolic disorders.
One fascinating study conducted in Japan shed light on the profound impact of emotions on blood sugar regulation. Participants who watched a funny movie before eating exhibited a better insulin response compared to the control group. This finding suggests that the emotional state in which we consume food can significantly influence our body’s physiological response to glucose, highlighting the importance of managing stress and cultivating positive emotions, especially during meal times. 9
So how can we build and nurture supportive relationships to improve overall well-being and reduce stress? Here are some suggestions:
- Prioritize quality time with friends and loved ones: Make an effort to maintain regular contact with supportive individuals in your life, whether through phone calls, video chats, or in-person interactions. Do not end a call or visit without scheduling the next one to keep consistency easier to maintain. When you see someone you haven’t seen in awhile, abolish the trite but hollow “We should get together sometime” and take the extra step to ask them to pull out their calendar and schedule something so it actually happens. You both will be much happier for it!
- Join community groups or clubs: Engaging in activities with like-minded individuals can help foster connections and provide a sense of belonging, reducing feelings of loneliness and isolation. Meet-up is still a great option! You can also check community bulletin boards at work or in your neighborhood coffee shops and community centers.
- Practice active listening and empathy: Reach out to those you care about and reconnect, bringing genuine interest their experiences and offering support and empathy if indicated. A listening ear can make a world of difference in someone’s life and show you how important you are to others as well.
- Seek professional support if needed: If you’re struggling with feelings of loneliness or isolation, don’t hesitate to reach out to a therapist or counselor for support and guidance.
Stress and Blood Sugar Are a Two Way Street
As you can see, there’s quite an intricate relationship between stress and blood sugar levels, and many ways in which they influence each other and impact our overall health and well-being, although the degree to which they may directly contribute to diabetes is still largely unknown. We do see some suspicious signals showing correlations in multiple areas of research. We do know temporary and chronic stress can lead to fluctuations in blood sugar levels through the release of hormones like cortisol and adrenaline, and we know that unstable blood sugar levels can, in turn, heighten our stress reactivity.
While it’s easy to look to food as the answer, the big takeaway from today’s episode is that it is just one level to pull, and boosting sleep quality and social support is equally important to managing stress and promoting stable blood sugar levels.
I hope that today’s information can help you take proactive steps to manage the stress in your life more effectively and support you in maintaining stable blood sugar levels!
Resources:
Blood Sugar Balancing Breakfast and Lunch Recipes download
- Brosolo, Gabriele et al. “Cortisol secretion and abnormalities of glucose metabolism in nondiabetic patients with hypertension.” Journal of hypertension vol. 42,2 (2024): 227-235. doi:10.1097/HJH.0000000000003590
- Walker, Rebekah J et al. “The influence of daily stress on glycemic control and mortality in adults with diabetes.” Journal of behavioral medicine vol. 43,5 (2020): 723-731. doi:10.1007/s10865-019-00109-1
- Gold, A E et al. “Changes in mood during acute hypoglycemia in healthy participants.” Journal of personality and social psychology vol. 68,3 (1995): 498-504. doi:10.1037//0022-3514.68.3.498
- Tudpor, Kukiat et al. “Psychological Stress Is a Risk Factor for Type 2 Diabetes Mellitus in College Students.” Studies in health technology and informatics vol. 285 (2021): 296-299. doi:10.3233/SHTI210619
- Tanaka, Teppei et al. “Psychological and traumatic stress and the risk of developing diabetes and psychiatric disorders after a disaster-relief mission: An eight-year longitudinal study of Japan Maritime Self-Defense Force personnel dispatched for the 2011 Great East Japan Earthquake disaster-relief mission.” Journal of psychiatric research vol. 146 (2022): 118-124. doi:10.1016/j.jpsychires.2021.12.046
- Nyberg, Solja T et al. “Job strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women.” Diabetes care vol. 37,8 (2014): 2268-75. doi:10.2337/dc13-2936
- Hackett, Ruth A, and Andrew Steptoe. “Type 2 diabetes mellitus and psychological stress – a modifiable risk factor.” Nature reviews. Endocrinology vol. 13,9 (2017): 547-560. doi:10.1038/nrendo.2017.64
- Tahrani AA, Ali A. Obstructive Sleep Apnoea and Type 2 Diabetes. Eur Endocrinol. 2014 Feb;10(1):43-50. doi: 10.17925/EE.2014.10.01.43. Epub 2014 Feb 28. PMID: 29872463; PMCID: PMC5983096.
- Hayashi, Keiko et al. “Laughter lowered the increase in postprandial blood glucose.” Diabetes care vol. 26,5 (2003): 1651-2. doi:10.2337/diacare.26.5.1651
