Stress and diabetes

Stress is defined as all of the body’s reactions when it perceives a demand for adaptation.

Diabetes: a source of stress

Diabetes is an agent of stress for several reasons:

  • Diabetes is a condition that is chronic, permanent and imposed (you didn’t choose to be diabetic).
  • The symptoms are usually present and disruptive.
  • You are dependent on a treatment and forced to change your lifestyle.
  • The treatment can cause side effects.
  • The risk of complications compounds already numerous frustrations.
  • The disease can undermine your self-image and self-confidence.
  • You may be a victim of prejudice and discrimination: at work, when dealing with an insurance company, in the eyes of others, etc.

Effect of stress on blood glucose (sugar) levels

Stressful situations associated with diabetes or to psychological conflicts unrelated to diabetes can upset the balance of your blood glucose levels. Stress can affect diabetes control in two ways:

The hyperglycemic effect of stress hormones.

In a stressful situation, the body reacts by secreting stress hormones: catecholamines (adrenalin, noradrenalin), cortisol, glucagon and growth hormones. These stress hormones cause blood glucose levels to rise in order to provide the body with the necessary energy to physically respond (flight or fight) to the stressor. However, in diabetics (especially in those whose diabetes is poorly controlled), the rise in blood glucose levels can persist if available insulin is insufficient or absent.

The way stress affects blood glucose levels varies from person to person. Consequently, stress might cause hyperglycemia, hypoglycemia or have no glycemic effect at all.

The effect of the strategies or behaviours used to cope with stress (eating more or eating less, excessive consumption of alcohol, etc.).

Similarly, severe stress can also weaken your motivation to participate in your treatment, hence in improving your blood glucose control.

Signs of stress

How you react to stress is based on your personality, ability to cope and resistance to stress. Everyone reacts differently.

The signs can be physical (sweaty palms, rapid heartbeat, menstrual problems), psychological (depression, weeping or inability to weep, irritability) or behavioural (aggression, memory loss, increased consumption of alcohol).

All of these are entirely human reactions. What’s important is to be aware of the emotion, let it in, express it, and figure out what the emotion is masking.

For example, anger can be a way of expressing a need for respect, to be heard, to be understood. Sadness can be a way of expressing a need to be heard, for support, for quiet reflection, for comfort. Fear can be a way of expressing a need for reassurance, for more understanding, etc.

Different reactions to stress:

  • Withdrawing from others can sometimes be helpful when you need to reflect on what you want to do with your life, but avoiding all human contact can lead to depression.
  • Dramatizing your condition will raise your stress levels, just as denying it won’t help you control it.
  • Putting your head in the sand won’t protect you from the harmful effects of diabetes.
  • It may be OK to have an occasional glass of wine or take a sleep aid once in a while, but excessive reliance on alcohol, drugs or sleeping pills is harmful and can lead to all sorts of other problems.
  • Asking for help doesn’t mean you are weak or dependant. It can help you deal with your problems as long as you take responsibility for them.

There are many ways to manage stress. Discover tricks for handling your stress.

Research and adaptation: Diabetes Québec Team of Health Care Professionals

Scientific review: Dr. Alain Janelle, Psychologist

July 2014 (updated on July 2018)

Adapted from:

Tremblay, Louise, M. Ed., Nurse. (Autumn 1997). “Stress et diabète,” Plein Soleil, Diabète Québec, p.33-34.

Gosselin, Marjolaine, Psychologist. (Spring  2000). “Le stress au détour du chemin,” Plein Soleil, Diabète Québec, p.25.

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