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Diabetes Complications Related to Stress

written by: AngelicaMD • edited by: Diana Cooper • updated: 5/10/2011

Stress is an important risk factor in developing complications from diabetes. Although stress is a normal part of life, diabetics may not handle overwhelming physical and emotional challenges well because hormonal mechanisms are defective. Learn more about stress and diabetes.

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    How the Body Reacts to Stress

    Stress as a normal part of life is handled differently by every person. But the body is programmed to react to different levels of physical, mental and emotional stressful situations to be able to overcome or cope with these.

    The brain and the endocrine organs work to release hormones and neurotransmitters responsible for organizing the rest of the body to deal with stress. The primary stress hormone cortisol is secreted in the bloodstream in higher amounts than normal as the body reacts with a fight-or-flight response to a stressful situation. At the same time, one’s adrenaline and noradrenaline levels are also increased. These endogenous substances normally keep the body physically and mentally alert, increasing energy, strength and immunity at the same time decreasing pain perception. Heart rate and blood pressure may rise and flushing, sweating and dryness of the throat may be experienced, as well as loss of appetite and sleep. However, after the immediate temporary response the body usually returns to normal state of balance with rest and relaxation.

    Diabetics usually have an imbalance of these stress hormones and may not handle their effects as well as non-diabetics. This is when stress related diabetes complications may arise.

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    Stress and Diabetes

    Stress responses can exacerbate diabetes mellitus and lead to complications. The sudden and rapid increase in cortisol in the blood results in the breakdown of stored proteins into sugar which the body uses for energy during stressful situations. However, in diabetics, this sugar is not absorbed or metabolized; instead it stays in the blood causing an increase in blood sugar levels or hyperglycemia. This is due to the absolute lack of insulin in the body (in diabetes type I) or a relative lack or resistance of the cells to insulin (diabetes type II). In either case, insulin, which is responsible for maintaining normal blood sugar levels, is not able to balance the increase in the effects of cortisol.

    Chronic increases in cortisol can lead to other complications. Along with insulin, cortisol encourages food cravings that lead to increased food consumption and obesity. The distressed individual usually seeks “comfort foods" in the form of carbohydrates that seem to decrease the emotional stress responses. This aggravates hyperglycemia, obesity and their complications such as atherosclerosis and heart disease.

    Along with these, stress appears to impair fat metabolism, leading to abdominal girth increase. This is a factor known to be associated with heart disease.

    Another complication of stress is related to the release of adrenaline and noradrenaline from the adrenal glands. In diabetics, these neurotransmitters may cause exaggerated increases in heart rate and blood pressure, resulting in arrhythmias and hypertension especially if the individual is already suffering from heart disease and atherosclerosis. While normal individuals can easily revert back to a state of balance, diabetics may have sustained or chronic responses that can lead to a worsening of these diseases. Heart attack, stroke and blood thickening are possible complications.

    Chronic stress can impair immune function of the body. The immune system may produce less white blood cells and more cytokines which predispose a diabetic individual to infection and other diseases like asthma and heart disease. Furthermore, hyperglycemia is also a factor in delayed wound healing and infection.

    Other complications of stress related diabetes may result in symptoms like:

    • Gastrointestinal disturbances – diarrhea, vomiting, constipation, abdominal pain
    • Sleep disturbances
    • Chronic pain and headaches
    • Sexual dysfunction – erectile dysfunction, inability to achieve orgasm and infertility
    • Impaired concentration, memory and mental ability
    • Skin and hair disturbances – itching, alopecia, and eczema
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    Preventing Stress Related Diabetic Complications

    Proper stress management can help prevent complications from stress in diabetics.

    Eating a low calorie, low carbohydrate and low fat diet will prevent unnecessary weight gain and increases in blood sugar levels. Regular exercise will not only reduce weight; it can also improve one’s emotional and mental well being. Along with the right medications and proper management of infections and other diseases, these can reduce the risk for obesity, heart disease, stroke and other complications of diabetes.

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    References

    UMMC, “Stress Complication", http://www.umm.edu/patiented/articles/what_health_consequences_of_stress_000031_3.htm

    WebMD, “Stress and Diabetes", http://diabetes.webmd.com/features/stress-diabetes

    American Diabetes Association, "Stress" ,http://www.diabetes.org/living-with-diabetes/complications/stress.html