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Stress: American Diabetes Association

May 19th, 2015 6:46 pm

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Stress results when something causes your body to behave as if it were under attack. Sources of stress can be physical, like injury or illness. Or they can be mental, like problems in your marriage, job, health, or finances.

When stress occurs, the body prepares to take action. This preparation is called the fight-or-flight response. In the fight-or-flight response, levels of many hormones shoot up. Their net effect is to make a lot of stored energy glucose and fat available to cells. These cells are then primed to help the body get away from danger.

In people who have diabetes, the fight-or-flight response does not work well. Insulin is not always able to let the extra energy into the cells, so glucose piles up in the blood.

Many sources of stress are long-term threats. For example, it can take many months to recover from surgery. Stress hormones that are designed to deal with short-term danger stay turned on for a long time. As a result, long-term stress can cause long-term high blood glucose levels.

Many long-term sources of stress are mental. Your mind sometimes reacts to a harmless event as if it were a real threat. Like physical stress, mental stress can be short term: from taking a test to getting stuck in a traffic jam. It can also be long term: from working for a demanding boss to taking care of an aging parent. With mental stress, the body pumps out hormones to no avail. Neither fighting nor fleeing is any help when the "enemy" is your own mind.

In people with diabetes, stress can alter blood glucose levels in two ways:

Scientists have studied the effects of stress on glucose levels in animals and people. Diabetic mice under physical or mental stress have elevated glucose levels. The effects in people with type 1 diabetes are more mixed. While most people's glucose levels go up with mental stress, others' glucose levels can go down. In people with type 2 diabetes, mental stress often raises blood glucose levels. Physical stress, such as illness or injury, causes higher blood glucose levels in people with either type of diabetes.

It's easy to find out whether mental stress affects your glucose control. Before checking your glucose levels, write down a number rating your mental stress level on a scale of 1 to 10. Then write down your glucose level next to it. After a week or two, look for a pattern. Drawing a graph may help you see trends better. Do high stress levels often occur with high glucose levels, and low stress levels with low glucose levels? If so, stress may affect your glucose control.

You may be able to get rid of some stresses of life. If traffic upsets you, for example, maybe you can find a new route to work or leave home early enough to miss the traffic jams. If your job drives you crazy, apply for a transfer if you can, or possibly discuss with your boss how to improve things. As a last resort, you can look for another job. If you are at odds with a friend or relative, you can make the first move to patch things up. For such problems, stress may be a sign that something needs to change.

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Stress: American Diabetes Association

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