Why Stress Makes Blood Sugar Go Up

And what you can do about it, no weight loss required.

The moment Kera, a patient with type 2 diabetes, sat down, her body seemed to deflate. Our customary greetings were exchanged, but Kera’s eyes were fixed on the carpet beneath her feet. 

“I am here when you are ready,” I said, not rushing the appointment. It was clear that something was up. A few minutes passed before Kera lifted her tear-streaked face to look at me. Her hands fiddled with her meter, and in a muttered breath, she said, “They aren’t very good.”

Kera was in the middle of a very stressful situation, driving her blood sugar up over 75 points from baseline. “What can we do at this session to help you?” I asked.

“Nothing.” Her eyes darted away as she explained the situation. She shifted in her seat and asked, “Why does stress make my blood sugar so high?”

I created the pause for her to connect how stress had thrown her system out of wack, interrupting sleep and eating patterns and shifting priorities, including the desire to manage her diabetes. My presence gave Kera the space to resist blaming herself. She was ready to see how stress triggers a series of hormonal dominos at a cellular level. 

The first domino is the catecholamine hormones, released into the body in response to physical or emotional stress; there are three primary catecholamines: dopamine, norepinephrine, and epinephrine. As catecholamines increase (think prolonged stress), they knock over the second domino, glucocorticoids. 

Glucocorticoids are steroid hormones produced from the cortex of adrenal glands that have a pivotal role in the glucose, protein, and fat metabolism of the body. Unfortunately, these hormones increase insulin resistance.

If you can imagine insulin as a knife, insulin resistance is a dull knife. No one wants to cut anything with a dull knife! Insulin resistance is the hallmark of type 2 diabetes, and research is showing that many people with type 1 diabetes can also experience insulin resistance as they get older.

Insulin resistance becomes the third domino in the series. In a 2022 review of stress and diabetes, the authors concluded that “diabetes may cause abnormalities in the regulation of these stress hormones.” Reading this, it is clear that stress makes diabetes worse, and diabetes changes how our body handles stress. 

Coping

There are lots of ways you respond to stress, but if you group them, they can be sorted into four responses. How and why you move these levers changes throughout your life. There isn’t a right or wrong way to cope, but many of us have a favorite lever, preferring one of the following over the others.

• Lever one is to face your emotions.

• Lever two is you can amplify/exaggerate your emotions

• Level three is to minimize/ignore them 

• Lever four is to deny them. 

Kera explained that she could no longer deny that there was a problem. She explained, “Initially, I denied my blood sugar was a problem, then I minimized the elevations. Acknowledging the third and fourth levers weren’t working was a massive step for Kera. She was about to pull the second lever, which would have amplified the feeling of failure when she came to the appointment. 

“Diabetes is hard.” Her face now looked up, and we made eye contact. I repeated the statement, “Diabetes is hard.” 

“You not disappointed that my blood sugar is elevated?”

“Sometimes blood sugars go up. That is part of diabetes. What I am curious about is how my disappointment in your blood sugar would help you or your blood sugars.” At this question, we both laughed. 

Diabetes is complex, requiring Kera to understand what worked for her. I reflected to Kera, “In this situation, you can see how stress creates a domino effect.”

“Yes.” I feel like I have to work harder because I can’t focus, so I skip my walk and lunch to make up the time. It causes my blood sugar to become erratic, making it harder for me to focus. 

“You came to this session expecting to get yelled at.”

“I did.”

“If I yelled at you, I would just be amplifying your emotions of anger and frustration.”

“Yes. I can see that.” Her voice filled with a bit more confidence.

I continued, “We revert to being a kid, looking for an authority figure to tell us we are bad, wrong, or not trying.”

“I’m not a kid. Diabetes isn’t my fault,” Kera repeated quietly under her breath.

“You get to have elevated blood sugar,” I stated.

“I get to have elevated blood sugar.” She parroted

“How does being allowed to be human feel?” I queried.

“Big. It feels big!”

“You don’t want to have elevated blood sugar, but you get to because that is part of your experience with diabetes.” I offered as a summary.

Acceptance of diabetes doesn’t stop stress. It doesn’t magically make blood sugar fall into target. Acceptance, however, helps you manage stress because it creates the space for you to be human. It allows you to be an imperfect human managing the challenging chronic condition called diabetes.