Stress And Diabetes: A Review Of The Links
Evidence suggests that stressful experiences might affect diabetes, in terms of both its onset and its exacerbation. In this article, the authors review some of this evidence and consider ways in which stress might affect diabetes, both through physiological mechanisms and via behavior. They also discuss the implications of this for clinical practice and care. In recent years, the complexities of the relationship between stress and diabetes have become well known but have been less well researched. Some studies have suggested that stressful experiences might affect the onset and/or the metabolic control of diabetes, but findings have often been inconclusive. In this article, we review some of this research before going on to consider how stress might affect diabetes control and the physiological mechanisms through which this may occur. Finally, we discuss the implications for clinical practice and care. Before going any further, however, the meaning of the term stress must be clarified because it can be used in different ways. Stress may be thought of as a) a physiological response to an external stimulus, or b) a psychological response to external stimuli, or c) stressful events themselves, which can be negative or positive or both. In this article, we address all three aspects of stress: stressful events or experiences (sometimes referred to as stressors) and the physiological and psychological/behavioral responses to these. Role of Stress in the Onset of Diabetes Stressful experiences have been implicated in the onset of diabetes in individuals already predisposed to developing the disease. As early as the beginning of the 17th century, the onset of diabetes was linked to “prolonged sorrow” by an English physician.1 Since then, a number of research studies have i Continue reading >>
Type 1 Diabetes: The Stress Of Type 1 Often Leads To Diabulimia
Living with type 1 diabetes means that you have a different relationship with food than other people. You live your life in between the demanding rituals that happen multiple times a day; before and after a meal or any type of snack. When I look down at my plate I don’t just see the food itself, I see numbers. After living with type 1 diabetes for over 23 years, I have calculated the nutritional components of thousands of meals while also considering time of day, activity level, stress, and many other necessary factors before deciding how much insulin I need to inject. Although I am now at peace with this routine, there were 10 years of my life where I lived in a fog. I grew tired of the unyielding routines that type 1 diabetes demands on a daily basis. I was afraid that others would see me as broken and fragile if I had a low blood sugar at an inconvenient time (and let’s face it, it’s always an inconvenient time to be low). What started out as an attempt to just keep my blood sugars a little higher than normal to avoid any possibility of a hypoglycemic attack during a performance or out on a date, quickly manifested into a dangerous eating disorder. I became lost inside a cycle of coping behaviors that soon became my entire life. Diabetes felt like an unfair burden to me and to my life’s goals, and I rebelled forcefully against it. I didn’t know how to ask for help and for years I didn’t know if I even wanted help; I had forgotten how to take care of myself and my eating disorder became my world. My life changed in many ways the day I finally shared my secrets to my family and my husband. I was lucky enough to receive treatment at one of the most qualified eating disorder treatment facilities in the country that has a fully developed treatment track for di Continue reading >>
Can Stress Cause Type 2 Diabetes?
The idea that stress can cause type 2 diabetes is not new but recent media coverage of Dave Dowdeswell from the UK who, along with his doctors, believe the only explanation for his diabetes is extreme stress, has prompted discussion around this idea as another possible explanation for why many fit and otherwise healthy people can develop type 2 diabetes. At 44 Mr Dowdeswell, a keen windsurfer and diver, was not overweight and had no family history of diabetes. However, in the 12 months prior to his diagnosis of type 2 diabetes he had experienced a series of traumatic life events. His doctors believe the extreme stress he lived through could have been the trigger for diabetes. One theory is that the stress hormone cortisol may alter the body’s sensitivity to insulin. While scientists are not in agreement over whether this means stress itself is a direct cause of diabetes or just a risk factor, there are some compelling arguments and research is continuing in this area. A recent contribution to the debate comes from research funded by the Department of Defense in the US that find links between post traumatic stress disorder (PTSD) in soldiers returning from Iraq and Afghanistan and an increase in type 2 diabetes, hypertension and obesity. The study is still in its preliminary stages and other factors are being investigated as to why some people develop PTSD in the first place (such as stress response genetics) but initial findings make a definite link between war-related stress and depression on poor general health outcomes. In 2013 a 35 year prospective follow-up study of 7,500 middle-aged men in Sweden found a strong link between stress and diabetes risk. Levels of stress were graded by the participants and it was found that men who reported permanent stress had a 45% Continue reading >>
Impact Of Stress On Type 2 Diabetes Mellitus Management.
Abstract BACKGROUND: Type 2 diabetes mellitus (T2DM) is one among the major health and socioeconomic problems worldwide. It is, however, not a somatic illness for which just symptomatic treatment will suffice. Stress is an important factor in not only causing diabetes onset or exacerbation, but also in hampering proper treatment by interfering with the treatment adherence of patients. Hence, it becomes important for physicians to acquaint themselves with the effects of stress on T2DM in order to ensure proper treatment of the latter. OBJECTIVE: Documentation of effect of stress on the management of T2DM. SUBJECTS AND METHODS: The research was a cross-sectional study on the patients attending Sri Muthukumaran Medical College, Hospital and Research Institute, Mangadu. A total of 400 people, who werepre-established diabetic patients of the hospital of age greater than 30 years, were chosen for the study. The stress levels of the patients were assessed with the Perceived Stress Scale (PSS) and treatment adherence using a questionnaire prepared exclusively for the study. Based on the data, a statistical relationship was framed between the degree of control (treatment adherence) and the stress levels of the patients. RESULTS: The FBS levels were a direct reflection of the stress levels (P<0.05). Stress had a major impact on treatment adherence among the diabetic subjects: Increased levels of stress decreased the adherence (P<0.001). The glycemic index (HbA1C level) was found to be linked to both treatment adherence and stress. Increased adherence kept it at bay (P<0.05) while stress proved abysmal to glycemic control. CONCLUSION: T2DM is the result of an interplay between various factors; environmental, psychiatric and somatic. Hence, a holistic treatment approach is required Continue reading >>
Mental Stress And Motivation In Type 2 Diabetes - Support Is Important!
back to Overview Type 2 You've just been diagnosed with diabetes. Now what? This question is a symptom of a situation that changes your whole life. And not only your life, but that of your friends and family, too. Studying stress In 2012 the most extensive study to date concerning psychosocial stress in diabetes was conducted, and finally the experiences of family members were taken into account. The DAWN2 study showed, among other things, that family members also experience psychological stress and worry about their loved ones with diabetes. This sounds obvious – of course they worry. But many of us with diabetes don’t realize how much they worry, and how much those around us want to help us! We think they’re not interested in diabetes support, but you’d be surprised just how much they care. Maybe we can learn together how they might best do it? Diabetes and mental health Diabetes and mental health is not to be taken lightly. Often people with diabetes feel enormous psychological pressure (sometimes self-imposed) which can make us reluctant to “come out” and share our struggles and challenges. It limits our opportunities to talk to other people about fears, concerns and thoughts. In addition, more and more people with diabetes feel discriminated against and experience a certain intolerance of their disease. Diabetes within the family can sometimes be a point of contention, and this wears on the family members just as much as the person living with diabetes. Isolation, intolerance, discrimination, conflict – is it any surprise that depression is common? The situation often feels hopeless, and the physical stress usually brings emotional baggage. It’s a vicious cycle, and the best tool to break free (or avoid it altogether) is a strong serving of motivati Continue reading >>
How Stress Affects Blood Sugar Levels
Two types of stress can change blood sugar levels: Physical stress Mental or emotional stress Each type of stress affects blood sugar levels differently. Physical stress generally causes blood sugar levels to increase. Physical stress includes: Illness Surgery Injury Mental or emotional stress has mixed effects, depending on the type of diabetes you have: Type 1 diabetes: Mental stress can increase or decrease blood sugar levels. Type 2 diabetes: Mental stress generally increases blood sugar levels. Stress also can affect your blood sugar levels indirectly by causing you to forget about your regular diabetes care routine. When you're stressed out, you might: Exercise more or less Eat more or less Eat less healthy foods Not test your blood sugar level as often Forget or delay a dose of medication and/or insulin mental stress can affect your blood sugar levels Use your diabetes logbook to discover if mental stress affects your blood sugar levels, especially if you have type 2 diabetes. Some people with type 2 diabetes are very sensitive to stress. It causes the body to produce especially high levels of stress hormones, which drive blood sugar levels up. follow these steps to find out if your blood sugar levels are affected by mental stress: Rate your stress level on a scale of 1 to 10, where 1 indicates the lowest stress level and 10 the highest; record your stress level in your logbook. Test your glucose using your home monitor and enter the result. After a week or two, study your results to see if there is a pattern or relationship between your stress level and your blood sugar levels. 3 ways to reduce mental stress Teach yourself to relax when under stress using deep-breathing exercises or techniques you learn in a stress-management class. Evaluate your schedule and de Continue reading >>
Stress And Diabetes Mellitus.
Abstract Stress is a potential contributor to chronic hyperglycemia in diabetes. Stress has long been shown to have major effects on metabolic activity. Energy mobilization is a primary result of the fight or flight response. Stress stimulates the release of various hormones, which can result in elevated blood glucose levels. Although this is of adaptive importance in a healthy organism, in diabetes, as a result of the relative or absolute lack of insulin, stress-induced increases in glucose cannot be metabolized properly. Furthermore, regulation of these stress hormones may be abnormal in diabetes. However, evidence characterizing the effects of stress in type I diabetes is contradictory. Although some retrospective human studies have suggested that stress can precipitate type I diabetes, animal studies have shown that stressors of various kinds can precipitate--or prevent--various experimental models of the disease. Human studies have shown that stress can stimulate hyperglycemia, hypoglycemia, or have no affect at all on glycemic status in established diabetes. Much of this confusion may be attributable to the presence of autonomic neuropathy, common in type I diabetes. In contrast, more consistent evidence supports the role of stress in type II diabetes. Although human studies on the role of stress in the onset and course of type II diabetes are few, a large body of animal study supports the notion that stress reliably produces hyperglycemia in this form of the disease. Furthermore, there is mounting evidence of autonomic contributions to the pathophysiology of this condition in both animals and humans. Continue reading >>
How Stress Can Actually Cause Diabetes
It’s not just donuts that can put you at risk: High stress levels may cause type 2 diabetes, research suggests. Psychologists interviewed more than 1.5 million Swedish men to see how well they coped with stress. The men were then tracked for 25 years to see if they developed diabetes. The guys with poor stress management were 1.5 times more likely to get the disease than those who were more resilient. Chronic stress screws with your body’s ability to regulate your blood sugar, says study author Casey Crump, M.D., Ph.D. That’s because high levels of cortisol, the hormone that plays a part in your fight or flight response, trigger high blood sugar. So when you’re in a constant state of anxiety, your body can’t bring your blood sugar back down to normal levels. Bad habits may also play a role, says Dr. Crump. “People who are stressed are more likely to eat unhealthy foods and have lower physical activity levels,” he says. “Those behaviors contribute to weight gain, which can also cause insulin resistance.” (For a fat-burning workout you can fit into the busiest of schedules, try THE 21-DAY METASHRED. You can do it in 30 minutes without even leaving your home.) Of course, you probably can’t quit your high-pressure job and move to Fiji. But if you manage daily demands better, you can trick your body into thinking you did. Related: 19 Ways to Live a Stress-Free Life Schedule one relaxing activity into each busy day, even if it’s just a 15-minute walk, says Adelaide Fortmann, Ph.D., the manager of diabetes care research at the Scripps Whittier Diabetes Institute. You’ll bring your cortisol levels down, and your blood sugar with it. Continue reading >>
Where It Comes From Â€” How To Deal With It
Stress is a major contributor to diabetes, but most people don’t understand what stress is or what to do about it. Here’s how stress works, and some things you can do about it. Say you’re walking down the street, and you bump into a hungry, man-eating lion. (Don’t you hate it when that happens?) You would sense a dangerous threat, and your body would automatically respond. Your adrenal glands would pump out a number of hormones. Chief among these is cortisol, which tells your liver and other cells to pour all their stored sugar (glucose) into your bloodstream. They do this so that your leg and arm muscles can use the glucose as fuel for running away, fighting, or maybe climbing a tree or a fire escape. At the same time, your other cells would become “insulin-resistant.” Insulin’s job is to get glucose into our cells to be used as fuel. In a crisis situation, most of your cells resist insulin, so the muscles involved in fighting or fleeing will have more energy. This reaction is called “stress.” In nature, the stress response is vital to survival. The antelope senses the lion (a threat) and runs. It either gets away or the lion eats it. In running, the antelope uses up the extra sugar and restores its hormonal balance. The whole thing is over in ten minutes, and the antelope can rest. But in our society, threat isn’t usually physical. When you’re threatened with job loss or eviction or the breakup of your marriage or a child’s drug problem or the thousands of other potential threats in modern society, you can’t fight, and you can’t run. You just sit there and worry. And the stress isn’t over in ten minutes either; modern stresses often act on us 24/7, week after week. Over time, insulin resistance builds up. It is a major cause of type 2 dia Continue reading >>
Type 2 Diabetes And Stress
What is stress, and how does it affect blood glucose levels in someone with type 2 diabetes? What is stress? Stress is a physiological response to a perceived attack or an event that produces strain. It can be triggered by a physical cause, such as injury, illness, or surgery. Or it can stem from an emotional reaction to problems with health, finances, or relationships. Stress can be "good" (an active vacation or a much-anticipated family visit) or "bad" (sickness, money woes, a family visit that turns contentious). It can be short term (getting stuck in traffic or catching a cold) or long term (dealing with diabetes or coping with an ailing partner). Stress takes a toll on the body. When the body feels stressed, it responds by triggering the fight-or-flight response, in which levels of certain hormones, such as adrenaline, cortisol, and epinephrine, kick in and shoot up. These stress hormones make a lot of stored energy -- specifically glucose and fat -- available to the cells to help the body escape from danger or get ready to do battle. Everyone experiences stress from time to time. But having many stressors or a long, intense, physical response to stress can lead to health problems such as headaches, migraines, digestive troubles, insomnia, anxiety, and depression, as well as changes in appetite and cravings for caffeine, alcohol, and sugar. How does stress affect people with type 2 diabetes? In people who have diabetes, the fight-or-flight response doesn't work so well. Insulin isn't always available to unlock cells and let that extra energy in, so glucose starts to back up in the blood. In addition, if someone with diabetes is dealing with an emotional stressor, his body may continue to pump out hormones with no end in sight, as neither fighting nor fleeing helps Continue reading >>
Stress And Diabetes – How To Cope With Emotions
In recent years, the complexities of the relationship between stress and diabetes have become well known and researched. The link between diabetes and stress has been found. One never forgets the moment of a diabetes diagnosis; a somber and profound memory that hounds for a lifetime, to say the least. While the physical impact of diabetes is well documented, the disease also wreaks havoc on emotional health. Your diabetes diagnosis can be devastating, as you grieve for lost health, and at the same time, try to come to terms with a restricted lifestyle, fear of developing complications, and the uncertainty of starting insulin therapy. All of this can be completely overwhelming, adding a huge emotional weight which can sometimes manifest as anxiety and depression. Add to that the stress of learning how to manage diabetes and live a healthy life despite it, and things don’t look too good for your emotional wellbeing. Truth is, stress and diabetes are closely linked, as your feelings will affect both your quality of life and diabetes management. Coping With A Diabetes Diagnosis If you have recently been diagnosed with diabetes, chances are that you’re going through a bevy of emotions. One of the hardest things to come to terms with is the fact that diabetes is a life-long condition. Even if you’re only prediabetic or your blood sugar levels are only slightly elevated and you still have time to reverse diabetes by eating right, exercising right, losing weight, etc., you still have to deal with the challenging emotions that accompany managing a potentially serious medical condition and making positive changes to your lifestyle. It is completely natural to feel low after your diagnosis. In fact, the link between diabetes and depression is well documented. With the right Continue reading >>
Can Stress Cause Type 2 Diabetes?
Stress is not a known cause of Diabetes. However, certainly the effects of stress and how one manages their stress can certainly contribute to the development of diabetes over time. Those who over eat and get less exercise may be at increased risk of obesity over time and this may contribute to the development of diabetes. Stress itself can be harmful to the body over prolonged periods and may cause the development of other health issues that may lead to diabetes down the road. After lots of studies and research, the best we can say is maybe. Stress can elevate blood glucose levels. Sometimes this is the direct effect of stress hormones. Other times, it's because stress leads people to eat more and be less active, which can also raise blood glucose levels. We know this is true for people who already have diabetes. So, it seems likely that if your blood glucose levels are already higher than normal (but not yet high enough to call it diabetes), stress could push your levels into the diabetes range. So the stress of a serious life event, such as the death of a loved one or the loss of a job, could play a part in developing diabetes. However, it is likely you would have eventually developed diabetes anyway as insulin resistance increased or insulin production decreased. Continue reading >>
Journal Of Insulin Resistance
Copyright: © 2016. The Author(s). Licensee: AOSIS. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective: Diabetes mellitus is considered an emotionally and behaviourally demanding condition which adds to the stress of a patient’s daily living. There is a paucity of literature in South Africa regarding stress and diabetes. This study therefore aims to identify the areas and contributory factors of psychosocial stress in South African patients with diabetes. Method: A cross-sectional study was conducted at two public facilities and five private medical practices on the north coast of KwaZulu-Natal, South Africa. The Questionnaire on Stress in Diabetes – Revised was administered to 401 participants. Results: Eighteen percent of the sample reported having extreme psychosocial stress. Depression, physical complaints and self-medication/diet were the main areas which contributed to high psychosocial stress. Factors that also contributed to high levels of psychosocial stress were low educational level, unemployment, female gender, attending the public sector and high HbA1c levels. Conclusion: Psychosocial stress affects metabolic control in patients with diabetes, thereby increasing the risks of long-term complications. The prevalence of diabetes mellitus (DM) has increased globally with an estimate of 415 million adults living with the disease in 2015.1 Type 2 diabetes is most common and affects millions of people worldwide.2 Diabetes prevalence has also rapidly risen in middle- and low-income countries.2 The International Diabetes Federation estimates that in Africa, 14.2 million adults h Continue reading >>
Diabetes Mellitus Type 2 And Stress: Pathophysiology And Treatment
Summary Psychological and physical stresses play a significant role in the development of hyperglycemia in the setting of type 2 diabetes. Although Thomas Willis demonstrated hyperglycemia in response to stress as early as the 17th century, results of subsequent animal and human studies are not consistent. This inconsistency exists despite clear physiologic evidence that stress hormones can cause hyperglycemia via modulation of the sympathetic nervous system. Studies, which use both behavioral and pharmacologic interventions to manage stress, offer mixed results regarding the ability of relaxation techniques to modify hyperglycemia. However, when the data are evaluated in the setting of a large meta-analysis, the evidence indicates that modification of stress leads to a modest reduction in hyperglycemia. Preview Unable to display preview. Download preview PDF. Continue reading >>
Does Emotional Stress Cause Type 2 Diabetes Mellitus? A Review From The European Depression In Diabetes (edid) Research Consortium
Specialty: Psychiatry, Epidemiology, Endocrinology Institution: Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University Address: Tilburg, Netherlands Author: Nina Kupper Specialty: Psychology, Biology Institution: Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University Address: Tilburg, Netherlands Author: Marcel C Adriaanse Specialty: Epidemiology, Psychology Institution: Section of Prevention and Public Health, Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam Address: Amsterdam, 1081 HV, Netherlands Abstract: According to the World Health Organization, approximately 220 million people worldwide have type 2 diabetes mellitus. Patients with type 2 diabetes not only have a chronic disease to cope with, they are also at increased risk for coronary heart disease, peripheral vascular disease, retinopathy, nephropathy, and neuropathy. The exact causes of type 2 diabetes are still not clear. Since the 17th century, it has been suggested that emotional stress plays a role in the etiology of type 2 diabetes mellitus. So far, review studies have mainly focused on depression as a risk factor for the development of type 2 diabetes mellitus. Yet, chronic emotional stress is an established risk factor for the development of depression. The present review provides an overview of mainly prospective epidemiological studies that have investigated the associations between different forms of emotional stress and the development of type 2 diabetes mellitus. Results of longitudinal studies suggest that not only depression but also general emotional stress and anxiety, sleeping problems, anger, and hostility are associated with an increased risk for the development of type 2 diabetes. Conf Continue reading >>