I had hoped that the summertime would give us time to reflect and relax with a slower pace and offer less responsibility. This definitely has not been the case. I have recently instructed several patients who are under a great deal of stress whether it is related to family issues, work, finances, or their own health problems.
Nobody seems to be short on stress these days, and multiple studies have proven that stress can have a negative impact on your general health. Having a chronic condition – including diabetes – can be affected even more by on-going stress. Stress makes the blood sugar rise in everyone because of a surge in hormones (including growth hormone, cortisol and epinephrine). These hormones are increased to give us a burst of energy to deal with a “fight or flight” situation. It does not matter if it is mental or physical, the hormones are still released.
Why do we get stress?
Stress can occur from an infection or fever, dealing with a relationship problem or coping with an intense job. People without diabetes have the capacity to regulate blood sugars – since they have enough insulin – which can be utilized to get the excess glucose into cells. Those with diabetes do not have enough insulin, or insulin that works efficiently, so their blood sugars rise and stay elevated. Having chronic, unrelieved stress with diabetes can lead to out of control blood sugars for long periods of time. Eventually this could cause complications including heart disease, hypertension, neuropathy, sexual problems, retinopathy, and nephropathy if not dealt with appropriately. Chronic stress may make you feel like giving up and resorting to unhealthy habits including smoking cigarettes, over-eating, or binge drinking. Stress may cause you to forget to refill or take your medications.
We all have stress, but let’s examine some ways to help cope with and manage it in a positive way.
Below are just a few choices of stress reducing techniques. Remember to always check with your health care provider to see if any of these methods are not right for you. You should consider combining them to achieve the best results.
- Massage. A massage from a professional therapist, family member, or partner can help reduce stress and anxiety. Studies have shown that human touch can drop cortisol levels up to 50%. Massage can also increase neurotransmitters called dopamine and serotonin, which can have a positive impact on mood. It can also help lower rates of depression. Massage has been documented to assist in decreasing blood pressure. Massage may boost T cells, which can increase immunity and help you fight off viruses (people with diabetes may have decreased immunity).
- Write in a journal. Many people find solace by writing in a journal and keeping track of what is causing them stress. Just as some people use food diaries to keep an ongoing record, others document stress experiences to become more aware of what is causing their daily stress. Write down your blood sugars when you feel stressed and look for patterns. The more you can recognize and feel the stress response and see a connection to blood sugars, the more you may want to focus on additional stress reduction techniques.
- Do what makes you happy. If focusing on a hobby brings you pleasure, set aside time for it. Many people like hobbies where they produce tangible items like knitting, painting, or quilting. Try not to achieve perfection or create a time limit on these projects – keep them creative. Take a warm bath and add aromatherapy, like lavender, to help you relax at the end of a long day. Lighting candles often will help you relax. Gardening can also be an outlet for stress. Find what you enjoy and make time.
- Cut down on caffeine. Most people get jittery and anxious when ingesting too much caffeine. Know how much you can tolerate. Caffeine can raise your blood pressure, heart rate, and cortisol levels, which add to your stress response. Read labels – since caffeine can be in products that you are unaware of.
- Eat, sleep and exercise on a schedule. When people are stressed, much of their routine can be lost. This is actually the most important time to maintain your regular routine. Although it may be difficult to sleep, take every opportunity to get a decent night’s sleep. Lack of sleep or interrupted sleep will also cause levels of cortisol (stress hormone) to rise. Try to focus on your eating plan. People tend to crave sugar, comfort foods, and snack foods when they are stressed – which again is the worst time to indulge, since your blood sugars are already elevated. Do not skip meals. Watch your portion sizes and stick to fruits, vegetables, lean proteins, low fat dairy and whole grain carbohydrates in moderation. Stay hydrated. Drink green decaffeinated tea. Stick to your exercise or start an exercise program when you are stressed. Exercise burns up the sugar, plus it increases insulin sensitivity so you can use your insulin better. A simple walk can help. Having and keeping a familiar routine often helps as well.
- Deep breathing and counting to 10. Often something triggers an acute stress response such as being in traffic or running late for work. There is no ability to go for a walk during these times, so consider deep breathing or counting to 10 to help reduce stress levels. Try visualization as well – focus on a calming mental scene like the ocean, waterfall or anything that pleases you.
- Meditation. Make time for a 15-20 minute meditation session, either at the beginning or end of your day. You can purchase a book, DVD, or watch an online video for examples of how it is done. Sitting or lying in one place for a extended period of time with no distractions and repeating a mantra is all that is needed.
- Yoga. Studies have shown that the rhythmic breathing and flowing motions of yoga can lower stress levels when done consistently. Yoga gives you a sense of well being and relaxation. Yoga can give you a wider range of motion, joint mobility, and help decrease injuries. It can also assist with balance, coordination, and strength. It teaches you how to breathe.
- Talk to a therapist or attend a support group. Some people are uncomfortable sharing their problems, but many find talk therapy a perfect way to help relieve stress.
- Professional cognitive therapy. This may help you figure out why you are having such trouble dealing with stress. It can help you understand if your aggravation is worth the situation. It can also give you ideas on coping and dealing with the situation in a more productive way.
- Progressive Relaxation. This can be done in a group setting with a leader, or on your own. It requires you to tighten or tense and then relax each muscle group in sequence. A study in Diabetes Care showed a correlation with progressive relaxation and a decrease in blood sugars.
- Read books, articles or on line resources on methods of stress management.
I am sure there are many more techniques to help you moderate your stress levels, but these are a good start. Reducing and managing stress will surely help reduce your blood sugars, future complications, and improve your overall health. Start practicing today!
NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.
She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.
She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.