How Stress Affects Type 2 Diabetes

If you have type 2 diabetes, stress management is crucial to keeping your blood sugar in check. These tips will help you balance stress and diabetes.

By Chris Iliades, MD

Medically reviewed by Lindsey Marcellin, MD, MPH

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In people with type 2 diabetes, the body doesn’t respond well to insulin — the hormone that removes sugar from your blood and helps get it into your cells where it can be used or stored for energy. Managing type 2 diabetes with exercise, diet, and sometimes medication usually keeps blood sugar under control, but stress may cause blood sugar levels to rise.

Stress is your body's normal response to danger. When you experience stress, your body reacts by giving a quick boost of energy from sugar, allowing you to “fight or take flight” and get out of danger. Everyone's blood sugar goes up when they’re under stress, but if you have type 2 diabetes, your body has a harder time getting your blood sugar levels to go back down to normal.

"Stress isn’t all bad," says Dinamarie C. Garcia-Banigan, MD, MPH, an endocrinologist and diabetes specialist at the Lahey Clinic in Burlington, Mass. "A little stress can help you use energy and improve concentration. But too much stress and type 2 diabetes can be a bad combination,” she says. “That's why stress management is an important part of managing type 2 diabetes."

The Link Between Stress and Diabetes

There are two reasons why stress could lead to a spike in blood sugar levels in people with type 2 diabetes. "One reason is that people under stress may stop taking care of their diabetes,” says Baha Arafah, MD, an endocrinologist at Case Western Reserve University School of Medicine in Cleveland, Ohio. “They may neglect to check their blood sugar levels, or they may stray from their diet and eat or drink too much."

Another reason is that stress increases the body’s demand for energy. “To get that energy, your body releases hormones that raise your blood sugar,” Dr. Garcia-Banigan says. “People without diabetes can make enough insulin to keep up with that sugar and get it into cells where it can be used, but if you have type 2 diabetes your insulin can't keep up with the high blood sugar levels."

Emotional and physical stress that may occur during an illness or injury can also cause the release of blood sugar that’s been stored in liver and muscle cells. “Stress hormones include cortisol, adrenalin, and growth hormone,” Dr. Arafah says. They all have the ability to increase blood sugar levels."

Stress Management for Type 2 Diabetes

If you have type 2 diabetes, the first step in stress management is to not let stress distract you from taking care of yourself. Continue checking your blood sugar levels, keep up with all of your testing and office visits, and don't react to stress by changing your diet or reverting to bad habits like smoking or drinking. "You need to identify the sources of your stress so you can start to deal with them in positive ways," says Garcia-Banigan. Here are some suggestions:

• Exercise more. Increasing the amount of exercise you get is a great way to burn off stress. Exercise can also help you reach or maintain a healthy weight and control your blood sugar. "If you can, you might want to bump up your exercise to about 60 minutes a day," Garcia-Banigan advises.
• Eat well. Maintaining good nutrition when you’re stressed helps control blood sugar levels. "You need to make sure to get the right nutrition so you have the energy to deal with stress," Garcia-Banigan says.
• Improve your coping style. Try replacing negative thoughts with positive thoughts, reducing the stress triggers you can, and being good to yourself. "Learn to manage your time well and make yourself a priority," Garcia-Banigan says.
• Learn stress reduction techniques. Breathing exercises, meditation, and progressive relaxation are all techniques that people have found to be helpful for stress management. Practice stress-relieving activities that work for you.
• Get support. Having a chronic condition like type 2 diabetes is stressful in itself. Talk to friends and loved ones about your feelings. Ask your diabetes caregivers about stress management assistance, and consider joining a diabetes support group where you can share feelings, ideas, and advice.

Type 2 diabetes requires constant attention, so don't let stress throw you off your game. One of the biggest keys for stress management with type 2 diabetes is education. The more you know about type 2 diabetes and how stress affects blood sugar levels, the better you’ll be at keeping both stress and diabetes at bay.