With almost 1.9 million Australians already living with diabetes and one person developing the condition every five minutes, diabetes is a big issue in Australia.
So is stress. In a survey covering 2020–21, the Australian Bureau of Statistics (ABS) found that 43.7% of adults had experienced one or more ‘personal stressors’ (experiences such as illness, breakdown of a relationship, bereavement or loss of a job) during that period.
Stress and diabetes are linked. Not only can stress contribute to the development of diabetes, but it can also negatively affect a person’s management of it; and living with diabetes can cause stress.
In this article, we’ll take a closer look at those links.
Stress and diabetes: what’s the link?
Diabetes is a condition where there are high levels of glucose in the blood. It is caused when the body is not able to produce insulin (a hormone that keeps blood glucose levels in a healthy range) or cannot produce enough of it.
Stress can contribute to high blood glucose levels. When a person experiences stress, their body releases ‘stress hormones’ adrenaline and cortisol. Cortisol causes the body to decrease its insulin secretion, which can result in blood glucose increasing.
As that happens, the pancreas releases more insulin until it becomes unable to make enough of the hormone to meet the body’s needs and cells become resistant to it. This is called ‘insulin resistance’, and it results in blood glucose levels rising further. If this process continues, a state called pre-diabetes develops. If pre-diabetes is not managed, it can develop into type 2 diabetes, the most common form of diabetes.
Stress can also indirectly affect the risk of diabetes through its impact on a person’s lifestyle. People who are under stress are more likely to experience poor-quality sleep, eat less healthy and exercise less.
People who are already living with diabetes may find that stress impairs their ability to manage the condition.
Blood glucose and stress
When we’re in a challenging, stressful situation, our body’s sympathetic nervous system triggers the ‘fight or flight’ response in an effort to keep us safe. Humans have always had this response to prime the body to deal with any stressful situation. Originally it helped us to do what you need to do when you meet a predator: run fast or fight hard. Both need higher amounts of energy. To provide this, the body releases into the bloodstream the ‘stress hormones’, cortisol and adrenaline.
These hormones increase your heart rate, blood pressure and breathing rate, pumping blood around the body faster to provide your muscles with extra oxygen. The stress hormones also stimulate the pancreas to release another hormone called glucagon. Glucagon causes the liver to convert stored glycogen into glucose, which is then released into the bloodstream, giving your body the energy necessary to fight or run away, even though neither course of action is likely to be appropriate in dealing with the stressors of modern life.
Insulin is a hormone that helps cells take in glucose for energy. Stress causes insulin levels to fall, resulting in more glucose remaining in the bloodstream. If a person is constantly in a stressed state, this can lead to chronically elevated blood glucose levels and potentially contribute to the development of diabetes.
As we’ve mentioned, stress can also increase the risk of diabetes through its impact on lifestyle choices. For example, overeating in response to stress may lead to weight gain, and weight gain, particularly around the waist, is a major risk factor for insulin resistance. Stress can also lead to poor-quality sleep, which has been linked to an increased risk of developing diabetes.
Diabetes and mental health
Research shows that living with a chronic condition such as diabetes can have a significant effect on a person’s mental health. Not only do you have to deal with its physical effects but you have to manage the condition day in, day out. As many as 75% of people with the condition report that they experience serious stress in their daily lives. There is an emotional state that is sometimes referred to as ‘diabetes-related distress’ or ‘diabetes-specific distress’. It is experienced by people managing the emotional burden of finding suitable support and care. It can also be triggered by the social impact of diabetes (such as stigma, discrimination or dealing with other people’s unhelpful reactions or lack of understanding).
Long-term stress can trigger depression, and if that happens to a person living with diabetes, they may feel less able to manage the condition. If you have decreased energy and are experiencing problems with concentration (which are both common symptoms of depression), you may feel less motivated to do regular exercise, take medication and/or stick to a healthy eating plan. Neglecting yourself in that way can increase your risk of diabetes complications such as heart, kidney, eye and foot damage.
Stress management for diabetes
As stress can impact the health of people who are living with diabetes, it’s helpful to learn ways of minimising its effects.
In general, getting enough sleep, exercise, rest and relaxation in your daily routine are beneficial in coping with stress. Steps that you can take include:
- Making sure that you’re active: physical activity can actually increase your stress response in the short term as part of the body’s ‘fight or flight’ response. However, after exercise, the body activates the parasympathetic nervous system, sometimes referred to as the ‘rest and digest’ state. This system helps to lower stress levels and return the body to a state of equilibrium. It regulates functions like your resting heart rate and your breathing rate, helping you to relax and recover after physical activity.
- Practising relaxation techniques: deep breathing, meditation, yoga and mindfulness reduce stress, promote a sense of calm and improve sleep patterns.
- Eating healthily: a nutritious diet is important. Eat plenty of fresh fruit and vegetables and avoid foods high in fat and sugar.
- Maintaining your social life: connecting with people who make you feel good about yourself helps to combat not only stress but also physical illnesses.
- Prioritising self-care: try to get involved in activities and hobbies you’ve enjoyed, even if you don’t feel like it to start with.
If you feel that you are suffering from stress, it is important to speak to your GP. GPs are trained to recognise the signs and symptoms of stress, and to deal with them. They can make a diagnosis of your condition and also check for any physical health problems or medications that may be making your symptoms worse.
Your GP can also provide you with information about stress and discuss your treatment options and preferences. It’s important to be honest with your doctor about how you feel so that they can give you the best treatment possible. If you find talking about your mental health difficult, taking a friend or family member along with you can be helpful.
Conclusion
Stress and diabetes are linked in several ways. Diabetes has a psychological and emotional impact that can negatively affect a person’s quality of life. Stress can cause blood glucose levels to rise and lead to unhealthy behaviours, all of which can lead to the development of diabetes. In people who are living with diabetes, stress can trigger depression, which can affect their management of the condition.
Fortunately, treatment and support is available for both stress and diabetes.
The Life! program offers a variety of tools that can help prevent or delay the onset of type 2 diabetes.
Life! is a free healthy lifestyle program that helps you improve your eating habits, increase your physical activity and manage stress. You can choose from a group course or the Telephone Health Coaching service.
Our experienced health professionals will help you make small changes to your lifestyle so that you can achieve your health goals and reduce your risk of type 2 diabetes and cardiovascular disease. Life! is funded by the Victorian government and managed by Diabetes Victoria. You can check your eligibility for the program here.
Sources
Anxiety. Symptoms, treatment and causes – Health Direct
Depression and Mental Health – Diabetes Australia
Depression. Symptoms, types, treatment – Health Direct
Diabetes in Australia – Diabetes Australia
General Social Survey: Summary Results, Australia, 2020 – Australian Bureau of Statistics
National Study of Mental Health and Wellbeing – Australian Bureau of Statistics
New research investigates links between stress, diet and type 2 diabetes – Diabetes Australia
Stress and trauma – Australian Institute of Health and Welfare
Stress as a driver of diabetes – Diabetes Australia
Stressors and bodily pain, 2020-21 – Australian Bureau of Statistics
