Stress is a broad term that can have a number of meanings. For the purposes of this question, only emo- tional stress will be discussed. Emotional stress (whether its source is personal, professional, psycho- logical, or social) can affect the blood sugar in a num-
ber of ways. The most frequent manifestation of stress
is the result of the rise in the circulating level of stress hormones in the blood. The stress hormones, such as epinephrine or adrenaline and cortisol, release stored glucose into the blood, thus raising sugar levels. They also make the tissues resistant to insulin. The result is a rise in blood sugar levels, which often leads to a need for more insulin or other medication.
Stress can also
affect blood sugar levels by its
effect on eating behavior.
individual but is quite unpredictable in different indi- viduals. It can vary from eating less and losing weight, to eating more or eating at different times, such as dur- ing the night. This can significantly alter one’s pattern of blood sugar readings. Also, significant amounts of stress often interrupt established patterns of exercise and leisure sports, which can cause blood sugars to rise.
Furthermore, a person’s adherence to a prescribed medical regimen often suffers during times of stress. The manage- ment of one’s diabetes can consume a considerable amount of a person’s time and attention and be a stress in itself. For this reason, people often reduce their frequency of glucose monitoring and sometimes the number of pre- scribed pills or injections that they actually take. Occa- sionally, this can have serious short-term consequences, but of significant concern is that people under prolonged stress who do not pay close attention to the management of their diabetes open themselves up to an increased risk of the serious long-term complications discussed in Part4. Therefore, if you are a person with diabetes under stress, it is wise to focus on addressing and relieving that stress in the interests of your long-term health.