Stress, both physical and mental, increases the risk of developing diabetes. Stress makes it difficult to control blood sugar in people living with the disease.
Several essential elements link stress and diabetes. Stress can be a risk factor for the onset of diabetes and a consequence of metabolic diseases.
In people with a genetic predisposition, high stress levels increase the risk of developing type 2 diabetes mellitus. While in people who are already living with diabetes, anxiety interferes with controlling their hemoglobin levels, glycosylated, and blood glucose (glycemia).
Stress is a defense mechanism against any physical or psychological stimulus that alters the body’s homeostasis. Faced with these situations, the hypothalamic-pituitary-adrenal hormonal axis activates, which allows the body to adapt to conditions of particular energy demand.
In the autonomic nervous system, there is a predominance of the sympathetic system, which increases the release of adrenaline and noradrenaline. In contrast, the activity of the hypothalamic-pituitary-adrenal hormonal axis increases the release of glucocorticoids, mainly cortisol.
Hyperglycemia, stress, and diabetes
Cortisol, known as the stress hormone, and adrenaline are the main effects of the symptoms associated with stress. Cortisol, adrenaline, glucagon, and growth hormone are counter-regulatory hormones. This means that they have an effect opposite to that exerted by insulin.
The increase in counter-regulatory hormones leads to hyperglycemia and peripheral resistance to insulin action. This explains how stress and diabetes are linked in their genesis.
Hyperglycemia occurs due to a breakdown of liver and muscle glycogen by cortisol. Glycogen is a storage form of glucose in the tissues, so it is released into the blood by the disposition of the stress image.
Additionally, there is an increase in glucose production in the liver from amino acids and triglyceride degradation factors. The result is again hyperglycemia.
Finally, peripheral insulin resistance is due to the inhibition of the insulin-dependent glucose transporter. This receptor allows, under normal conditions, the entry of glucose into adipose tissue and striated muscle. When inhibited, glucose continues to circulate in the blood.
Neuronal damage due to stress hyperglycemia
In case of stress associated with an acute injury (basic illnesses, injuries, or surgeries), the state of systemic inflammation adds to its harmful contribution. These are situations with increased release of pro-inflammatory cytokines, such as tumor necrosis factor-alpha and interleukin 1.
These factors produce increased glucose uptake in the central and peripheral nervous systems. Neurons, therefore, become more susceptible to damage from high blood sugar.
It’s not just hyperglycemia.
While stress can trigger diabetes in predisposed individuals, it is a chronic disease associated with other factors. Stress is another element.
Diabetes results from a defect in the secretion or action of insulin, resulting in prolonged hyperglycemia. However, like any chronic condition, a large percentage is attributed to unhealthy lifestyle habits, such as improper diet, sedentary lifestyle, and irregular sleeping patterns.
Stress and diabetes management
Chronic stress can trigger diabetes not only through hormonal mechanisms but is also associated with adopting unhealthy lifestyle habits that further increase the risk of hyperglycemia. Stress-promoting lifestyle habits include a poor diet, smoking, and excessive alcohol consumption.
Additionally, abnormal hormone levels are associated with weight gain and an increased waist-to-hip ratio. The waist-to-hip ratio is an essential indicator of diabetes and the possibility of suffering from cardiovascular disease.
This is why stress management techniques, such as mindful breathing, muscle relaxation, cognitive restructuring, physical activity, and social support, among others, have a crucial impact on blood sugar control…American Diabetes Association recommends approval of mind and body to people with diabetes.
To reduce stress, the following measures are recommended:
- Exercise for at least 30 minutes a day.
- Seek social support from friends or family.
- Try meditation or mindfulness.
- Having a hobby or hobbies.
- Maintain a balanced diet.
- Sleep properly.
Diabetes control also involves healthy lifestyle habits.
Many sources of long-term stress are mental. The mind tends to react to harmless events as if they were a real threat.
In people who do not have diabetes or a genetic predisposition to it, these stimuli can be channeled. However, in other cases, hyperglycemia is induced.
Similarly, stressed people are more likely to have unhealthy lifestyle habits. They drink alcoholic beverages, exercise less, and don’t plan their meals.
Type 2 diabetes mellitus is linked 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 it all.
People with diabetes who report feeling stressed do not take their medications well and do not follow healthy lifestyle guidelines. Added to this is chronic stress, a risk factor for other chronic diseases, such as cardiovascular disease.
It is, therefore, clear that the approach of patients living with diabetes and stress is complex. Medications are not enough; mechanisms must be put in place to reduce anxiety and profoundly change lifestyle habits.