The Link Between Diabetes and Stress

Feeling stressed about having diabetes? It is natural. Stress and diabetes are connected, which is why you need to be aware of your state of mind as well as your body if you have the disease, whether Type 1 or Type 2.

Type I diabetes is considered an autoimmune disease. The immune system mistakes the body’s own healthy cells as foreign invaders. In response, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. Once these cells are destroyed, the body is unable to produce insulin, the hormone that regulates the movement of sugar or glucose into the cells, where it is used for energy.

Diabetes Type 2, the most common type of diabetes, also is a lifelong condition. With Type 2, the pancreas does not produce enough insulin, or cells respond poorly to insulin and do not take in enough insulin. While diabetes Type 2 can potentially go into remission, it remains a lifelong condition you will have to manage.

A global survey[1] by the International Diabetes Federation in late 2024 found that 77% of 1,880 people with diabetes experienced anxiety, depression, or another mental health issue related to their condition.

·         83% cited the fear of developing diabetes complications

• 76% experienced diabetes burnout, often because of daily demands and the strain of diabetes management. Daily diabetes self-care includes glucose testing, foot care, exercise, dietary changes/food preparation, and taking multiple medications.
• 58% noted diabetes stigma and discrimination
• 55% cited a fear of needles

Stress and diabetes risk

While diabetes can bring on stress, stress also can contribute to getting diabetes. A 2020 scientific review found that depression as well as general emotional stress and anxiety – along with sleeping problems, anger and hostility – are associated with an increased risk for the development of Type 2 diabetes. [2]

Stress can impact blood sugar levels

Stress and diabetes come into play because when you are under stress, your body releases hormones – adrenaline and cortisol - that can cause blood sugar levels to increase. That is why you will want to track when you feel stressed and how it affects your glucose levels to see what kind of patterns emerge. If you notice your glucose level is high when you are feeling stressed about something or at some time of the day or week, take special steps to lower your stress during these periods and keep your glucose under control. [3] 

Also, stress can lead to unhealthy behavior, including poor eating habits or smoking, which can result in high blood pressure, heart disease and obesity. These conditions can make managing your diabetes even more challenging.

Stress symptoms

The symptoms of stress can be both physical and mental. [4] Among the physical symptoms of stress, you may experience:

·         Headaches

·         Muscle pain or tension (The release of cortisol and adrenaline when you are stressed results in increased heart rate, elevated blood pressure, and muscle tension. Over time, this chronic state of arousal can lead to muscle tension and soreness, resulting in body aches and pains.[5])

·         Sleeping too much or too little

·         General feelings of illness

·         Fatigue

Stress also can cause you to feel:

·         Unmotivated

·         Irritable

·         Depressed

·         Restless

·         Anxious

Stress and diabetes risk of depression

Stress and diabetes increase risk of depression. Dealing with a life-threatening illness such as diabetes even can cause depression, which results in poorer health outcomes. The CDC reports that people with diabetes are 2 to 3 times more likely to have depression than people without diabetes. Only 25% to 50% of people with diabetes who have depression get diagnosed and treated. But treatment—therapy, medicine, or both—is usually very effective. And without treatment, depression often gets worse, not better. [6]

CDC notes that symptoms of depression can be mild to severe, and include:[7]

·         Feeling sad or empty

·         Losing interest in favorite activities

·         Overeating or not wanting to eat at all

·         Not being able to sleep or sleeping too much

·         Having trouble concentrating or making decisions

·         Feeling very tired

·         Feeling hopeless, irritable, anxious, or guilty

·         Having aches or pains, headaches, cramps, or digestive problems

·         Having thoughts of suicide

Diabetes stress management

While some level of stress will always be with you, there are ways to manage and reduce it.  Here are some tips for diabetes stress management:

Try to remain positive: It is easy to focus on the negative when things challenge or trouble you. But it is important to find good in each area of your life – your work, family, friends and even your health. Focusing on the good can boost your spirits during the bad times.

Plan: Use tools to help plan meals, medications, and medical appointments to reduce the stress that comes from staying on top of your diabetes management.

Talk to your health care providers about your feelings: Once you acknowledge your distress, talk to your doctor, nurse, diabetes educator and any other health care providers who are part of your care and treatment. They can help solve your concerns and may suggest other health care providers who can help.

Talk to friends and family: Your friends and family can be a great source of help in relieving stress. However, they also may add to the stress even without knowing it. Be open with them about your feelings and let them know when you need them to help you.

Connect with others who have diabetes: Look for others who are living with diabetes on social media or diabetes organizations. Connecting with others who have diabetes can make you feel less alone.

Exercise daily: Exercise is a great way to reduce stress. Also, when you are active, your cells become more sensitive to insulin, which then works more effectively to lower blood glucose levels. [8] Riding a bike, gardening, dancing, cleaning house and even playing with your pets are activities that are easy to incorporate into your daily routine.

Try meditation: When you meditate you focus your attention and clear your mind of thoughts to give you a sense of calm and peace and achieve balance. Meditation can help you gain a new perspective, increase self-awareness, increase self-control, and improve focus and decision making.

Practice deep breathing and yoga: Deep breathing exercise can reduce stress.  Yoga involves paying attention to your breathing, which can help you relax and help reduce stress.

The key to managing stress is to pay attention to what you are feeling. Once you know what is causing you stress, you can find ways to deal with it.

Pay attention to what you are feeling. Once you identify the cause of your stress, find ways to manage and if possible, eliminate it to help keep your diabetes under control.