I still get surprised when patients get surprised when I tell them that stress and emotions can affect their blood sugars. In most cases it will raise the blood sugars, but occasionally it may drop them. Remember the stress hormone is cortisol. By now most of you know that glucocorticoids -a type of steroids (prednisone and cortisone) similar to cortisol causes resistance to the actions of insulin thus causing blood sugars to rise if your body can’t produce enough insulin to compensate. Because of that increase in insulin, patients on these glucocorticoids can gain weight. Their bodies need more insulin and insulin is a storage hormone (meaning stores the calories that we consume in our muscles and fat cells). So the more insulin you need, the more weight you will gain.
So how can we reduce stress so that we can keep our blood sugars and weight balance? Certainly it is easier said than done, but we can always try. I have seen some of my patients who can never achieve control of their blood sugars no matter how much technology we incorporate in their diabetes regime until the day that they retire from their work. Unfortunately most of us are in no position to just quit a job-but one we learn to rewire our brains in order to better cope with stress.
A simple strategy that I would like to share in this piece is social interaction. That is our relationships with our family, friends, and coworkers- even strangers in the supermarket. Sometimes all it takes is interchanging a smile with someone- it can really lighten up your day. Many times as people feel stress- say by too much homework, work, personal problems – they tend to withdraw from their loved ones, friends and it seems- from the world. They want to be alone in their misery and that is the worst thing to do. On the contrary they need to talk to their friends, counselors, spiritual guides – even to us doctors- and share what is “eating" them. As a patient with diabetes once told me: sometimes (the elevation of Blood sugars) is not what you are eating, but what is eating you!