I remember being on vacation and not needing my standard amount of insulin. I didn’t understand why my blood sugars were so stable and almost normal until I understood how stress effects just about everything.
Oh, and everything is connected. I found that even if I’m stressed out or having an anxiety attack (which happens more than I’d like to admit), my blood sugar skyrockets —even if I inject the appropriate quantity of insulin. On the contrary, if all I have to worry about is what bathing suit I need to wear to the beach, it seems like I need less insulin.
This is not a coincidence.
I mean, listen to this. According to Insulin Nation, an online platform for all things diabetes, our livers serve as a storehouse for glucose (sugar), keeping it in a concentrated form called glycogen. The liver breaks down small amounts of glycogen all the time, releasing glucose into the bloodstream to nourish our brain, nerves, heart and other active organs.
The liver’s release of glucose largely depends on the presence of certain hormones. Of all the hormones in our body, only insulin causes the liver to take sugar out of the bloodstream and store it in the form of glycogen. All other hormones —including stress, sex, growth, and glucagon cause our liver to secrete glucose back into the bloodstream.
This is normal.
Emotional stress (fear, anxiety, anger, excitement, tension), as well as physiological stress (illness, pain, infection, injury), can cause the body to secrete stress hormones into the bloodstream. When this happens to a non-diabetic, the sugar rise is usually modest and temporary.
This is because their pancreas works properly and the process continues. However, for those of us with diabetes, stress can cause a significant and prolonged increase in our blood sugar levels because our pancreas isn’t doing its job.
Here’s What You Need to Know
Anxious moments and nerve-racking situations happen to all of us. It’s inevitable. From public speaking to test-taking —even a simple visit to your doctor may elicit a stress hormone response that causes, among other things, a sharp blood sugar rise.
This one time, I was running late for an important meeting, hit a freaking pothole, got a flat tire, then discovered that the spare tire was also flat —and waiting for AAA to get there, exacerbated everything. Even without the slightest bit of food, my blood sugar rose almost 300 mg. And the kicker is (like I said in the beginning) when I’m not stressed, it seems as if my sugars are frequently lower.
So, it would seem that if we can avoid stress, we will feel better, right? In theory, yes —but that’s the thing about life and diabetes. It’s unpredictable. How can we permanently avoid stress?
Well, it’s pretty much impossible, which makes all of this frustrating, to say the least. It feels like any little thing sets me over the edge. I’m either too high or too low and unfortunately, I’m also a stressed person by nature. Add controlling my blood sugar levels with stress management and it’s like a job all by itself.
As a patient, I tend to blame myself for out of range blood sugars —after all, the equation to “good diabetes management” is supposedly simple (eat right, exercise regularly, and take your medication).
But have you ever done everything right and still went too high or too low? I have and I continue to. The bottom line is that diabetes is very complicated, and for even the most educated and diligent patient, it’s impracticable to keep track of EVERYTHING that affects your levels.
So when you see an out-of-range glucose value, don’t judge yourself —use it as information to make better decisions next time around.
Here’s What You Can Do About It
Of course, different events cause different responses in different people. What causes a great deal of anxiety for you might have no effect on someone else (although it seems everything stresses me out).
That said, the key is to look for patterns. Is there something that causes a consistent blood sugar response in a given situation? It can be helpful to record the causes of your high blood sugars in a journal, and then tally the causes to determine whether specific situations account for a large number of high readings.
Many anxious moments occur spontaneously. However, some can be predicted. And if you can predict it, you can prevent it. If you notice a consistent pattern of high blood sugars during certain events, consider giving yourself a small dose of insulin an hour or two prior to the event. This will help to offset the stress hormones produced in anticipation of the event as well as the event itself.
I know that all of this sounds great on paper. Trust me. You say you’re going to do one thing and then your sugar goes up and you simply can’t. That’s the easiest way to put it. When you feel good, you essentially will (or at least want to) do good. And don’t you want to feel good? I know I do.
Start by not condemning yourself because that’s just increasing your stress. Learn from yesterday so you can have an enjoyable present and an even better tomorrow. Because even though I have diabetes and I never know what’s going to happen next, I have the tools to get there. And now, you do too.