HEALTH PLUS MED­ICAL COR­RE­SPON­DENT

Di­a­betes man­age­ment is a life­long process. This can add stress to your dai­ly life. Stress can be a ma­jor bar­ri­er to ef­fec­tive glu­cose con­trol. Con­stant stress from long-term prob­lems with blood glu­cose can al­so wear you down men­tal­ly and phys­i­cal­ly. This may make man­ag­ing your di­a­betes dif­fi­cult, thus, cre­at­ing a Vi­cious Cy­cle.

Stress and your Hor­mones

If you are ex­pe­ri­enc­ing stress or feel­ing threat­ened, your body re­acts. This is called the fight-or-flight re­sponse. This re­sponse el­e­vates your hor­mone lev­els and caus­es your nerve cells to fire. Cor­ti­sol is com­mon­ly known as the stress hor­mone. It can stim­u­late the pro­duc­tion of glu­cose in the body and raise a per­son’s blood sug­ar.

Dur­ing this re­sponse, your body re­leas­es adren­a­line and cor­ti­sol in­to your blood­stream and your res­pi­ra­to­ry rates in­crease. Your body di­rects blood to the mus­cles and limbs, al­low­ing you to fight the sit­u­a­tion. Your body may not be able to process the ex­cess glu­cose re­leased if you have di­a­betes. If you can­not con­vert the glu­cose in­to en­er­gy, it builds up in the blood­stream. This caus­es your blood glu­cose lev­els to rise or spike!

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

Peo­ple with ab­nor­mal hor­mone lev­els may no­tice their Waist-To-Hip Ra­tio in­creas­ing, this means that the size of the waist is be­com­ing larg­er than the hips with in­creased adi­pose tis­sue. This is an im­por­tant risk fac­tor for com­pli­ca­tions of di­a­betes and car­dio­vas­cu­lar dis­ease.

What are the symp­toms of stress?

Some­times, the symp­toms of stress are sub­tle and you may not no­tice them. Stress can take a toll on your men­tal and emo­tion­al well-be­ing, and it can al­so im­pact your phys­i­cal health. Recog­nis­ing the symp­toms can help you iden­ti­fy stress and take steps to man­age it.

If you’re stressed, you may ex­pe­ri­ence:

- headaches

- mus­cle pain or ten­sion

- sleep­ing too much or too lit­tle

- gen­er­al feel­ings of ill­ness

- fa­tigue

If you’re stressed, you may feel:

- un­mo­ti­vat­ed

- ir­ri­ta­ble

- de­pressed

- rest­less

- anx­ious

How can you de­ter­mine if men­tal stress is af­fect­ing your glu­cose lev­els?

Keep­ing track of ad­di­tion­al in­for­ma­tion, such as the date and what you were do­ing at the time you were stressed, may help you de­ter­mine spe­cif­ic trig­gers. For ex­am­ple, are you more stressed on Mon­day morn­ings? If so, you know now to take spe­cial steps on Mon­day morn­ings to low­er your stress and keep your glu­cose in check.

You can fig­ure out if this is hap­pen­ing to you by cap­tur­ing your stress and glu­cose lev­els. If you feel stressed, rate your lev­el of men­tal stress on a scale from one to 10 with 10 rep­re­sent­ing the high­est lev­el of stress. This will be use­ful if you de­cide to see a ther­a­pist.

Af­ter rat­ing your stress, you should check your glu­cose lev­els. Con­tin­ue do­ing this for the next cou­ple of weeks. Be­fore long, you may see a pat­tern emerge. If you no­tice that your glu­cose is con­sis­tent­ly high, it’s like­ly that your men­tal stress is neg­a­tive­ly af­fect­ing your blood sug­ar.

How to cope with di­a­betes-re­lat­ed stress

If you’re feel­ing stressed about your con­di­tion, ac­knowl­edg­ing that you aren’t alone is the FIRST STEP. The next step may in­volve your health care team. We en­cour­age all pa­tients to feel com­fort­able in be­ing open about your stres­sors with your health care physi­cian.

WHAT CAN YOU DO AT HOME?

- Re­duc­ing men­tal stress

- Med­i­tat­ing can help re­move neg­a­tive thoughts and al­low your mind to re­lax.

- Con­sid­er start­ing each morn­ing with a 15-minute med­i­ta­tion. This will set the tone for the rest of your day.

- Sit in a chair with your feet firm­ly plant­ed on the floor and your eyes closed.

- Re­cite a mantra that makes sense to you, such as “I will have a good day” or “I feel at peace with the world.” Push away any oth­er thoughts as they en­ter your head, and al­low your­self to be present in the mo­ment.

Re­duc­ing emo­tion­al stress

If you find your­self in an over­whelm­ing emo­tion­al state, TAKE A PAUSE…take a few min­utes to be by your­self. Re­move your­self from your cur­rent en­vi­ron­ment. Find a qui­et space to fo­cus on your breath­ing. Try this mind­ful­ness prac­tice:

Put your hand on your bel­ly, and feel it rise and fall. In­hale deep breaths, and ex­hale slow­ly and loud­ly. This will slow your heart­beat down, and help bring you back to a sta­ble emo­tion­al state. This act of cen­tring your­self may im­prove how you deal with what­ev­er is caus­ing the stress.

Re­duc­ing phys­i­cal stress

Adding yo­ga to your dai­ly rou­tine can pro­vide both phys­i­cal ac­tiv­i­ty and med­i­ta­tion at the same time. Prac­tic­ing yo­ga can low­er your blood pres­sure, too. Whether it’s yo­ga or an­oth­er form of ex­er­cise, you should aim for 30 min­utes of car­dio­vas­cu­lar ex­er­cise per day. You can do 10 min­utes of ex­er­cise when you wake up, 10 min­utes in the af­ter­noon, and 10 min­utes be­fore you go to sleep.

YOUR MIND MAT­TERS

Al­though di­a­betes can present a unique set of chal­lenges when com­pli­cat­ed by stress, it is pos­si­ble to man­age it ef­fec­tive­ly and lead a hap­py, healthy lifestyle. Un­der­stand­ing the di­men­sions of stress and prac­ti­cal cop­ing strate­gies to pro­tect your mind is key to con­trol­ling the de­bil­i­tat­ing se­que­lae of Di­a­betes.