What is the connection between stress and diabetes?

Stress can trigger diabetes or make it more difficult to manage. How? Read the answer here.

What is the connection between stress and diabetes?

Latest update: May 16, 2023

Stress and diabetes are linked by several key elements. Stress can be a risk factor for the development of diabetes, but also a consequence of metabolic diseases.

In people with a genetic predisposition, high stress levels cause an increased risk of developing hypertension diabetes mellitus type 2. While in people already living with diabetes, stress disrupts control of their glycosylated hemoglobin and blood glucose (glycemia) levels.

Understanding stress

Stress is a defense mechanism against any physical or psychological stimulus that threatens to alter the body’s homeostasis. In these situations, the hypothalamic-pituitary-adrenal hormone axis is activated, allowing the body to adapt to situations with special energy needs.

During stress, there are adjustments that are carried out by nervous and hormonal mechanisms.

In the autonomic nervous system, there is a predominance of the sympathetic system, resulting in an increased release of adrenaline and norepinephrine. While the activity of the hypothalamic-pituitary-adrenal hormonal axis results in an increased release of glucocorticoids, with a predominance of cortisol.

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Hyperglycaemia in stress and diabetes

The adrenal glands
The adrenal glands secrete more cortisol in stressful situations. This affects the action of insulin.

Cortisol, often it stress hormone mentioned, and adrenaline are the main effectors of stress-associated symptoms. Cortisol, adrenaline, glucagon and growth hormone are known as counter-regulatory hormones. This means that they have the opposite effect to that of insulin.

The increase in counter-regulatory hormones leads to hyperglycemia and peripheral resistance to the action of insulin. This explains how stress and diabetes are related in their origin.

Hyperglycaemia is caused by the breakdown of liver and muscle glycogen by cortisol. Glycogen is a form of glucose storage in tissues, so that glucose is released into the blood by the disposition of the stress image.

In addition, there is one increased glucose production in the liver, from amino acids and triglyceride-degrading factors. The end result is again hyperglycemia.

Finally, peripheral insulin resistance results from inhibition of the insulin-dependent glucose transporter. Under normal conditions, this receptor allows glucose to enter adipose tissue and striated muscles. When inhibited, glucose continues to circulate in the blood.

Neuronal damage from stress hyperglycemia

In cases of stress associated with acute injury (underlying illnesses, injuries or surgeries), the state of systemic inflammation adds its detrimental contribution. These are situations with an increased release of pro-inflammatory cytokines, such as tumor necrosis factor-alpha and interleukin-1.

These factors lead to increased glucose uptake in the central and peripheral nervous system. Neurons therefore become more susceptible to damage from hyperglycemia.

It’s not just hyperglycemia

While it is true that stress can be a trigger for diabetes in predisposed people, it is diabetes a chronic disease associated with other factors. Stress is just another element.

Diabetes arises from a defect in the secretion or action of insulin, causing persistent hyperglycaemia. But like any chronic disease, a large percentage is attributed to unhealthy lifestyle habits, such as inadequate nutrition, a sedentary lifestyle and irregular sleeping patterns.

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Addressing stress and diabetes

Stress and diabetes
High stress levels complicate daily routines that are considered healthy. It is more difficult to eat well, rest and exercise.

Chronic stress can trigger diabetes not only through hormonal mechanisms (Spanish link), but is also associated with the adoption of unhealthy lifestyle habits that further increase the risk of hyperglycaemia. Until these stress-induced lifestyle habits include a poor diet, smoking and excessive alcohol consumption.

In addition, abnormal hormone levels are associated with weight gain and an increased waist-to-hip ratio. The waist/hip ratio is an important marker for diabetes and the risk of cardiovascular disease.

Stress management techniques, such as paying attention to your breathing, muscle relaxation, cognitive restructuring, physical activity, and social support, have an important impact on glucose control. The American Diabetes Association recommends taking care of both mind and body in people living with the condition.

To reduce stress, the American Psychological Association recommends the following:

  • Move at least 30 minutes a day.
  • Find social support with friends or family.
  • Try meditation or mindfulness.
  • Take a hobby or have hobbies.
  • Provide one balanced diet.
  • Provide enough and enough sleep.

Managing diabetes also requires healthy lifestyle habits

Many sources of long-term stress are mental. The mind often reacts to events that are innocent, as if they were a real threat. In people who do not have diabetes or a genetic predisposition to diabetes, these stimuli can be channeled.

In other cases, however, this will provoke hyperglycaemia. Also have people with stress more often have unhealthy lifestyle habits. They tend to drink alcoholic beverages, exercise less and not plan their meals.

Diabetes mellitus type 2 is related to environmental factors, such as obesity, a sedentary lifestyle, a diet high in fats and carbohydrates, smoking, abnormal cholesterol levels and high blood pressure. Stress is often behind all of these factors. People with diabetes who report being stressed do not take their medications adequately and do not adhere to healthy lifestyle guidelines. In addition

chronic stress is a risk factor for other chronic diseasessuch as cardiovascular disease. It is therefore clear that the management of patients living with diabetes and stress is complex. Medication alone will not suffice. Anxiety reduction mechanisms and major lifestyle changes will also need to be introduced. Perhaps also interesting for you

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