Consultancy corner: Is stress linked to diabetes?

On further evaluation, we found that she was deeply stressed due to the loss of a near and dear, few weeks ago. It took several visits to the counselor to get her life and diabetes back on track after learning to cope with her loss and decrease her stress levels.

Stress can be defined as “a physical, chemical or emotional factor that causes physical or mental tension and may be a factor in disease causation”. Several diseases can be caused or worsened by stress and diabetes is definitely one of those conditions which can be produced or aggravated by stress.

Blood glucose levels are controlled mainly by two groups of hormones. The first group reduces blood sugar, but insulin is the only member of this group. The second group called ‘counter-regulatory hormones’, opposes the action of insulin and thus increases the blood sugars. There are several of these hormones including cortisol, adrenaline, noradrenaline, glucagon and growth hormone. Stress tends to increase the levels of these counter-regulatory hormones. If the levels of these hormones remain persistently elevated, this can precipitate diabetes in a predisposed individual or worsen the diabetes control in someone who already has the disorder. 

It is important to detect high stress levels, since the blood glucose levels will come down only if the stress is relieved. Doctors should always think of stress when they see any patient with unexplained high sugars, or in someone whose diabetes is not under control in spite of optimum use of diet, tablets and insulin. Reduction of stress often leads to dramatic improvement, or even reversal of diabetes.

Very often, individuals do not realise that they are under stress or they tend to deny it. The first step in stress management is therefore to make the individual understand that everyone in the world is exposed to some stress or the other at some time in their lives. In fact, experts believe a mild degree of stress may actually be good for us as it raises our level of performance. However, one should also be alert to the signs and symptoms of excess stress, as they may be quite subtle and yet can be serious and often become extremely dangerous. 

One should try and accept stressful situations as “challenges” and not as “threats”. Many doctors tend to treat symptoms of stress with anxiolytic or anti-depressive medications without tackling the root cause of the stress. This approach could lead to harmful side-effects. Therefore, the correct and certainly the first step would be to use stress management techniques like healthy eating, daily exercise, meditation, yoga and other forms of de-stressing which may be individualised. The help of a qualified clinical psychologist or counselor is helpful in identifying the root cause of the stress. 

A healthy social life, taking time out to relax with friends and family is vital in reducing stress levels, thereby reducing the risk of developing diabetes and helping people with diabetes take control of their condition. It is particularly important that a person with diabetes learns how to manage stress, since stress can play havoc with the management of diabetes.