Research Links Stress Hormone to Diabetes

Stress has long been known as a “silent killer” for its contributing role to many chronic diseases, including the six responsible for the most American deaths each year. Yet evidence is mounting that the nation’s growing problem with high-pressure living can exacerbate conditions like diabetes, making a once-manageable disease even more challenging to live with.

Research has found that both physical and mental stress can cause a cascade of hormonal reactions in the body that directly and indirectly impact blood glucose and insulin. When under pressure, our bodies produce cortisol, commonly referred to as “the stress hormone.” Elevated cortisol levels may increase risk factors for type 1 and 2 diabetes through their relationship with the body’s ability (or inability) to process blood sugar by way of insulin. What’s more, the added stress that comes from living with these diseases — including physical complications, special dietary concerns, and the financial burden of expensive prescriptions — can worsen symptoms, causing even higher stress levels, in what can become a vicious cycle.

The unfortunate reality is that the issue of stress and its impact on our health is unlikely to dissipate, given the combination of lifestyle factors, economic and societal pressures affecting today’s American.  An annual survey conducted by the American Psychological Association has found a statistically significant uptick in the nation’s stress levels — even well ahead of the hectic holiday season. And it’s definitely impacting our collective health, with stress-related concerns accounting for more than three-quarters of all doctor’s office visits annually.

Now, research shedding light onto the role of cortisol has led medical experts to suggest that in addition to a prescribed medical regimen, a reduction in stress can play a significant role in keeping symptoms of diabetes under control.

Cortisol’s two main functions are to prep your body for action — in other words, that fight or flight response you always hear about — which it does by releasing glucose to fuel muscles and temporarily suppressing insulin production so you use glucose as energy, rather than store it as fat.

All this serves to increase blood glucose levels. Under normal conditions, a healthy, non-diabetic pancreas will counteract that by pumping out insulin. The problem occurs when chronic stress keeps cortisol elevated and your pancreas can’t keep up, which means blood glucose levels remain high. High blood glucose, or high blood sugar as it’s commonly referred to, is a significant risk factor for developing type 2 diabetes. Cortisol has also been linked to weight gain, another risk factor for diabetes. In people who already have type 2 diabetes, complications from the disease increase cortisol activity, according to a study published in the journal Diabetes Care.

While there’s no evidence of a direct link, researchers theorize that extreme psychological stress experienced in childhood may cause an autoimmune reaction that could result in a type one diabetes diagnosis, down the road. This has led some experts to believe that stress may explain the rise of type 1 diabetes cases.  A Swedish study of nearly 10,500 children found that experiencing a major life stressor — such as a family death or severe illness, divorce, or intense family turmoil — tripled the risk of the child developing type 1 diabetes by age 14, even correcting for other known risk factors such as genetics.

While some stressors are unavoidable, chronic stress can usually be managed before it wreaks havoc on your health. If you suspect you may be experiencing unusually high or persistent levels of stress, an adrenal stress index (ASI) test, (available as a home kit), can analyze whether cortisol levels are within normal range. The test measures the level of stress hormones present in saliva, which you’ll need to have analyzed by a lab. A less scientific, but perhaps more practical, method, especially for diabetics already measuring blood glucose levels, is to journal blood sugar and stress levels daily and look for patterns and/or connections. Stress can also manifest in physical ways, including fatigue and headaches.

Combatting stress and managing diabetes, requires a full lifestyle approach. Exercise can be a great stress reliever since it releases endorphins (the feel-good hormones that can be thought of as cortisol’s counterpart). Aim for 30 minutes of cardiovascular exercise — walking, running, biking — each day. Yoga also has proven benefits to reducing the harmful effects of stress on the body, as does meditation. Even more important: Make sure you’re getting enough sleep — quality and quantity ­— since lack of it has been linked to increased levels of cortisol too.

There’s also plenty of evidence that a healthy diet can impact how your body handles stress, particularly for diabetics. Stress can sometimes lead to skipping meals or overeating, both big don’ts for anyone with blood sugar issues. Additionally, recent research shows that an anti-inflammatory diet may help lower cortisol levels naturally. Talk to your doctor for a complete list of diabetes-friendly, anti-inflammatory foods and about which diet is best for you.

Whether you have diabetes or just know someone who does, it can be helpful to join a community of people in a similar situation. There are myriad support groups available for connecting with other diabetics both online and off.

November is National Diabetes Month and World Diabetes Day is November 14^th, a good time to find resources and support for diabetes care, prevention, and treatments, including how to manage everyday stress.

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