How are diabetes and stress linked?

Diabetes and stress appear to be related by several important elements. That is, stress can both contribute to, and be a consequence of, diabetes.

For example, a person may feel their stress levels increase when they have to plan meals and measure their blood sugar, especially in the early stages of a diabetes diagnosis. However, stress can also increase a person’s blood sugar and glycated hemoglobin levels.

Research has also linked high levels of stress throughout life to an increased risk of developing type 2 diabetes.

In this article, we discuss how stress affects blood sugar. We also look at what the research says about the best ways for people with diabetes to reduce stress.

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How does stress affect diabetes and blood sugar?

Researchers have been discussing the potential link between diabetes and stress since the 17th century.

More recent research suggests that people with depression and anxiety have an increased risk of developing type 2 diabetes.

A 2010 review article reports that people who experience depression, anxiety, stress or a combination of these conditions are at increased risk of developing diabetes.

Scientists found that several stressors can increase a person’s risk of developing diabetes, including:

  • stressful life events or traumatic experiences.
  • general emotional stress
  • anger and hostility
  • job stress
  • sleep difficulties

Researchers at the University of Amsterdam in the Netherlands have suggested possible explanations for how different types of stress can lead to diabetes. These include lifestyle factors, effects on hormone levels, and effects on the immune system.

These explanations for how stress affects diabetes are only theories. Some researchers have even found conflicting evidence about the relationship between diabetes and stress. For these reasons, researchers should continue to study these two conditions to determine if and how they are related.

We provide more details on these three factors in the following sections:

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Stress affects lifestyle factors.

High levels of stress can cause a person to adopt unhealthy lifestyle habits. These lifestyle habits can increase a person’s risk of developing diabetes. These include:

  • eating an inadequate diet
  • low levels of exercise
  • smoking
  • excessive alcohol consumption

Stress affects hormones

Another explanation is that emotional stress can affect a person’s hormone levels, potentially altering insulin function.

Stress can activate the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. This can lead to hormonal changes, such as higher levels of cortisol and lower levels of sex hormones. The levels of these hormones affect insulin levels.

Cortisol is commonly known as the stress hormone. It can also stimulate glucose production in the body and raise a person’s blood sugar.

People with abnormal hormone levels may notice that their waist-to-hip ratio increases. An increased waist-to-hip ratio means that the waist size is becoming larger than the hips. This is a major risk factor for diabetes and cardiovascular disease.

Stress affects the immune system

Chronic stress can also affect the immune system.

In one study, researchers noted that a particular immune system response to chronic stress is a similar response to that involved in the development of type 2 diabetes.

How can I tell if stress is affecting my blood sugar levels?

To determine if stressful events are causing a rise in blood sugar, people can measure their blood glucose throughout the day. They should note how they feel and when they last ate.

They can then show the readings to their doctor for analysis.

If the doctor notices that stress may be affecting blood sugar, he or she will explore different techniques to help control stress levels.


Reduce stress levels

The American Diabetes Association recommends that people with diabetes take care of their mind as well as their body.

Stress can contribute to and be a consequence of diabetes. However, there are many effective ways to relieve stress.

The strategy that works best for one person may be different for another. Exploring different options can help find the ideal strategy for everyone.

A 2018 study conducted at a clinic in Iran found that participating in social-related stress management training could improve blood sugar control in people with diabetes. Stress management techniques can help people manage their glycated (or glycosylated) hemoglobin levels.

Doctors use glycosylated hemoglobin levels to assess blood sugar control over the past 3 months. Improving glycosylated hemoglobin will reduce the risk of diabetes-related complications.

People with diabetes and stress may have lower glycated hemoglobin levels if they practice stress reduction techniques. Strategies that increase one’s coping efficacy and perceived social support can be effective. Below are some examples you can try:


Researchers have studied mindfulness-based stress reduction techniques in people with diabetes.

In a 2018 study, 29 people with diabetes received mindfulness sessions and training, while 30 people in the control group did not. People who received the training had significant improvements in their mental health outcomes and measures of diabetes control, including fasting blood glucose and glycosylated hemoglobin.

Managing Anger

People with diabetes who feel angry should try to figure out why they feel this way.

Understanding the cause of the anger is a step in the right direction toward solving the problem. The American Diabetes Association provides the following tips for managing angry feelings:


  • take deep breaths once or several times, if necessary.
  • drink water
  • sit down
  • lean back
  • shake out your arms
  • try to quiet the mind
  • go for a walk

Strategies to reduce stress

The American Psychological Association recommends the following strategies to reduce stress:

  • Try to take a short break from the stressor, which could be, for example, a big project or an ever-rising credit card bill.
  • Exercise as often as possible, such as walking, jogging or swimming for 20 minutes.
  • Smile and laugh to release stress from the muscles in your face.
  • Seek social support from a friend or family member.
  • Try meditation or mindfulness.

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