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Written by Jordan R. Wagner BSN, RN, CDCES
The Science and Implications:
I’m sure you’ve heard of stress hormones or heard people say that stress can impact blood sugars. This is certainly true, but it’s clear to me that most people don’t understand how significant stress can be on the body and blood sugars. To start, let’s look at the adrenal glands and some of the main stress hormones with their functions.
The adrenal glands are located on top of the kidneys and sometimes referred to as the suprarenal glands. Although small compared to other organs, they are vital for life. They are composed of two main layers. The outer cortex and the inner medulla
The cortex is further divided into 3 layers: the zona glomerulosa, zona fasciculata, and zona reticularis. Each layer secretes different hormones important for different body functions. I am going to focus on the hormones that impact glucose levels, but remember the adrenal glands do much more than regulating glucose levels.
Cortisol is a hormone secreted by the zona fasciculata of the adrenal cortex. It is made in stressful times to make a person more alert and have energy to handle the stressful situation. As stress occurs, the hypothalamus in the back of the brain makes corticotropin releasing hormone (CRH) which signals the the pituitary glad towards the middle of the brain to make Adrenocorticotropin hormone (ACTH) to signal the adrenal glands to make cortisol. Cortisol is secreted to help with the following:
Blood sugar regulation (through carbohydrate, fat, and protein metabolism)
Blood pressure regulation
Sleep regulation
Along with many other important roles.
Epinephrine (adrenaline) and norepinephrine are secreted by the inner medulla of the adrenal glands and function as both hormones and neurotransmitters. In acute situations of stress neuronal stimulation (an impulse from a neuron) signals the medulla to make both of these neurotransmitters which help to do the following:
Increase glucose levels by breakdown of glycogen that is stored in the liver.
Increase heart rate and narrow focus by activating alpha and beta adrenergic receptors.
Now that we’ve covered some of the basic functions of these hormones, let’s look at how they can truly impact glucose levels and diabetes management.
Prolonged exposure to these stress hormones can raise blood glucose levels and increase resistance to insulin. In our modern day society, this is a particularly strong component to the increase of diabetes diagnoses. We are stressed out all the time, not taking time to relax and unwind. Our bodies are in a constant state of fight or flight and it’s taking a toll.
For people who have diabetes, glucose levels tend to increase and remain elevated for hours after exposure to stress hormones. For people without diagnosed diabetes, but may be experiencing some glucose challenges like with prediabetes, the glucose levels will often increase and remain elevated, but not go as high. However if this continues repeatedly for years, the body begins to have more and more difficulty in managing the glucose levels and a diabetes diagnosis may be made. Take a look at these examples of simulated CGM graphs in response to stress.
So what can be done to manage this? The simple answer is relax. Set time aside for yourself to unwind, relax, and breathe. The constant “go, go, go” is without a doubt harming you physically. If you have diabetes, it’s likely making it more difficult to manage. I notice it myself, I require larger amounts of insulin in stressful times compared to nonstressful times.
Now you might be saying, “really... he’s telling me to lower my stress… that’s not possible with my life.” I guarantee you it is. Get some paper out and make a list of your ideal day then write down your daily stressors. This stress inventory gives you a visualization of what is happening. Create S.M.A.R.T goals (specific, measurable, attainable, realistic, timely), and track progress. This is one of many things you can implement today to help you lower your stress levels.
My personal experiences and stress management:
I am a Christian, my faith in Jesus as the Lord and savior of my life is of the utmost importance to me. Because I believe that He is alive, I also believe that He hears my prayers. Prayer is a major part of stress relief for my life. Take a look at what the scripture says about prayer in regards to anxiety.
“do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.”
Philippians 4:6-7
Furthermore, this quote by John Piper illustrates the importance of prayer.
“Prayer is the open admission that without Christ we can do nothing. And prayer is the turning away from ourselves to God in the confidence that He will provide the help we need. Prayer humbles us as needy and exalts God as wealthy.”
I realize that every breath I take, every bite of food, my diabetes supplies and ability to manage it is a blessing from God. This realization and acknowledgement leaves me in awe. There is nothing that God cannot handle and when I completely accept this and pray to the Lord, I feel my stress is instantly lowered.
The physical results of this peace and joy felt is better controlled blood sugars, lower blood pressure, better sleep, etc… but even if these “benefits” did not come, how can I not give thanks for my life?
If you do not know the Lord, I’d encourage you to read the Bible (I'm a big fan of the ESV study Bible). You’re always welcome in my local church body in Gilbert, AZ or you can watch online.
Final thoughts:
Uncontrolled or unmanaged stress will increase insulin resistance and lead to challenges in controlling blood sugar levels. It is important to find a healthy outlet for your stress. A stress inventory can help you identify where stress is coming from and help you realize where change is needed. If you are needing help in managing your diabetes, contact me or take a look at some of my blood sugar guides. We can set up a one time consult or find a program that will help you take charge of your diabetes.
*This article does contain affiliate links and links to some of my services. There is no obligation, I just want to disclose this information to readers.
References:
My own schooling and clinical experience.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/adrenal-glands
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