Dr. V. Mohan & Ranjani Harish
Stress is simply a fact of nature—forces from the outside world affecting the individual. Thus, stress is 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 among many such diseases.
Pic courtesy: The Telegraph.co.uk
Also read: All you need to know about Diabetic Foot
How does stress affect the blood sugar levels?
The blood sugar levels are controlled mainly by two groups of hormones. The first group of hormones 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 increases the blood sugars.
There are several of these hormones and the list includes cortisol, adrenaline, noradrenaline, glucagon and growth hormone. Stress tends to increase the levels of the counter-regulatory hormones, particularly cortisol, adrenaline and noradrenaline. If the levels of these hormones are 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 in a patient, since the blood sugars 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 the optimum use of diet, tablets, and insulin. Reduction of stress often leads to dramatic improvement or even cure of diabetes.
How does one deal with stress?
Very often, individuals do not realize that they are under stress and even if they do, they deny it. The first step in stress management is to make the patient accept that they are under stress. 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 even 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 approach would be the use of stress management techniques like healthy eating, daily exercise, meditation, yoga and other forms of de-stressing which may be individualistic in nature. For some people it may be cooking, somebody else gardening etc.
The help of a qualified clinical psychologist or counselor in identifying the root cause of the stress and to suggest ways to cope up can be of great help in many cases as they would often have more time to spend with the patient than a busy physician.
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.
We have seen many patients who were able to reduce their dose of drugs and some who were able to completely stop all anti-diabetic medications, once they dealt with their stress. Find out if stress is the cause of your diabetes, and if yes, please start stress management measures today. Stress is a part and parcel of modern fast life. Hence, you cannot avoid stress but you can certainly manage it!
Tips to cope with Stress and Diabetes:
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Mrs. S, a 52-year-old lady with normal weight and well-controlled diabetes were a patient who believed in regular follow-up for the management of her diabetes. However, her recent visit to the center revealed that she was coming after a year and presented with abnormally high blood sugars – over 500 mg/dl.
Despite our best efforts to control her with high doses of insulin and tablets, the sugar remained above 350 mg/dl. On further evaluation, we found that she was stressed due to the loss of a near and dear one, a few months ago. It took Mrs. S a visit to the counselor and a few months more to get her life and diabetes back on track after learning to cope with her loss and thereby the stress.
Pic courtesy: curejoy.com