Stress and Diabetes 5 Steps to Minimize Your Risk

Article written and reviewed by Cyrus Khambatta, PhD
Published March 1, 2022

Stress -- We're All Dealing with It

We all experience stress – yet we may experience it in very different ways. Because of this, there is no single definition for stress, but the American Institute of Stress states the most common explanation is a "physical, mental, or emotional strain or tension."

So what does this broad definition mean to you? Your stress might come from various sources, some of which are quickly identified while others not so much. Worrying about the current news cycle, a health problem, your family, or your job; these are all familiar sources of stress. But what about growing families, a new job, or planning a family vacation? Even seemingly positive events can negatively affect your stress levels.

This long-term emotional stress can prove to be more than just a mental issue. It can manifest itself in physical ways. From headaches to stomach disorders to depression – even severe problems like stroke and heart disease can come from stress.

Why is that? When you confront stressful situations, specific stress hormones rush into your bloodstream leading to an increase in heart rate, blood pressure, and glucose levels. This physical state is helpful in emergencies, but having this "rush" for extended periods can be dangerous and make you susceptible to certain chronic conditions, like high blood pressure and diabetes.

Does Stress Influence Diabetes?

Studies are relatively straightforward: stress raises your blood glucose in the short term.

The rise in glucose happens because these elevated emotional stress levels can elicit a biological fight-or-flight response. When stressed, your adrenal gland releases cortisol, a hormone that stimulates your liver to release glucose into your blood.  When you’re chronically stressed, your adrenal gland secretes cortisol at all times, which can raise your blood glucose in both the fasting and post-meal state.   in the long-term, this can be very damaging for both your mental health and your immune system. For more information on this process, check out our recent post here which takes a more in-depth look at stress and diabetes. 

Stress on People without Diabetes 

Most healthcare professionals agree that this initial stress response is universal to people with diabetes and without. This also includes the long-term effects of chronic stress, like a strained immune system, and blood glucose control.

However, for individuals who already have difficulty keeping their blood glucose low due to diabetes, these spikes in blood glucose can be more pressing and dangerous.

Stress on Individuals with Prediabetes or Type 2 Diabetes

Claiming that stress causes prediabetes or type 2 diabetes isn't entirely accurate. What is more accurate is that the physical response to stress and the habits that are often associated with stress all contribute to a higher risk for prediabetes and type 2 diabetes.

Many of the behaviors stressed individuals exhibit — comfort eating, not exercising as much as they'd like, poor sleep, elevated consumption of drugs and alcohol, weight gain, and a poor diet — are all risk factors for prediabetes and type 2 diabetes.

In this way, stress indirectly increases your risk of prediabetes and type 2 diabetes through physical responses. It's also likely that many of the habits you might resort to during times of stress may also contribute to the development of prediabetes and type 2 diabetes.

Stress on Individuals with Gestational Diabetes

Gestational Diabetes Mellitus (GDM) is a pregnancy-related form of diabetes that can occur suddenly during pregnancy. Its risk factors are similar to other forms of diabetes, including a previous history or family history, problems with diet and exercise, poor sleep, obesity, or preexisting high blood glucose. However, gestational diabetes has been noted to compound with the already-existing stress of pregnancy to create an unfortunate feedback loop.

If you're concerned about your stress levels or overall health, it might be worth reaching out to your doctor if you're thinking about getting pregnant to help prepare yourself as best as possible.

However, if you're dealing with an unplanned pregnancy or currently dealing with GDM, the good news is that some small changes can turn this negative GDM feedback loop into a positive one. This is because many of the behaviors that reduce stress can also reduce your risk of GDM and type 2 diabetes and help combat insulin resistance.

Be sure to read our definitive guide to gestational diabetes to get a comprehensive overview of how to prevent and reverse it.

Strategies for Reducing Your Stress

Since stress seems to follow us everywhere and there is simply no avoiding it, the task for all individuals, whether living with diabetes or not, is to find ways to best manage our stress. Fortunately, there are several strategies we can employ ourselves to reduce stress.

Eat a Low-Fat, Whole-Food, Plant-Based Diet

Your diet can play a huge part in helping reduce oxidative stress (caused by those harmful free radicals floating around in your body) and inflammation, both of which contribute to the physical effects of stress. Upping your daily intake of whole fruits and vegetables and reducing or eliminating your consumption of animal fats is a solid first step to helping minimize the effects of stress.

Incorporate Daily Movement and Exercise 

According to the Mayo Clinic, almost any exercise or movement can increase your fitness level while decreasing your stress. The most important thing is to pick an activity that you enjoy. 

Remember, you don't need a gym membership to go walking, stair climbing, jogging, dancing, or bicycling. You can also practice yoga, get out in the garden, or swim in the pool. Try to set up a habit of daily movement, even if it is just a 10-minute walk after dinner.

Change Up Your Routine

Sometimes we can prevent sources of stress by planning our regular routines. If you know the morning rush is a pain, perhaps set your alarm 30 minutes earlier and have your lunch ready to go. If bills are a significant pain point, consider sitting down and creating a budget to help ease the checkbook. 

And, you might consider placing a higher priority on sleep, daily exercise, and meal prepping, all of which might take a little planning on your part, but can pay off big in the long term.

Seek Out Social Activity and Community

Isolation and loneliness can add to our emotional stress. We often try to shoulder stress alone when a support system might be a better option. Talking with a spouse, confidant, or even a group of friends can help alleviate stress. 

A social community, such as a volunteer association or civic group, can also give you a sense of belonging to help combat isolation. If you are currently living with any form of diabetes, you might consider joining our Facebook group dedicated to providing community-like support to help you manage your health more easily.

Work with a Professional

No matter how physically healthy you are, no matter how successful, where you come from, or your age, it's still possible to feel too stressed. And while there are strategies for stress reduction and stress management that we can recommend — like eating healthier and making time for physical activity — sometimes your wellbeing needs a little more assistance.

In these cases, we recommend reaching out to a mental health professional or your doctor for some guidance as to a treatment plan to help overcome stress.

Participate in Stress Awareness Month

While stress doesn't directly cause diabetes, it can affect your blood glucose levels, and the work it takes to manage your diabetes can be stressful. Since April is Stress Awareness Month, we hope you will take time to reflect on the sources of stress in your life and find steps to start reducing its impact.

We've briefly touched on some of the steps to help manage your stress here, but if you also want to learn more about managing your diabetes, there are many options. One excellent first step you might take is to read the New York Times Best Seller Mastering Diabetes.

If you're looking for someone to guide you on your journey, you can get all the steps in our DIY Program, or work with an expert diabetes coach through small-group coaching or one-on-one training

Thousands of people have had results and love it - and you can get those results too. In fact, we guarantee it if you work with us

The Mastering Diabetes Community is always here to provide nutritional, informational, and social support to help you meet your new goals, so what are you waiting for? 

It's time to start making some new daily habits that will aid your health and make you feel great along the way. It's time to Master Diabetes.

About the author 

Cyrus Khambatta, PhD

Cyrus Khambatta, PhD is a New York Times bestselling co-author of Mastering Diabetes: The Revolutionary Method to Reverse Insulin Resistance Permanently in Type 1, Type 1.5, Type 2, Prediabetes, and Gestational Diabetes.

He is the co-founder of Mastering Diabetes and Amla Green, and is an internationally recognized nutrition and fitness coach who has been living with type 1 diabetes since 2002. He co-created the Mastering Diabetes Method to reverse insulin resistance in all forms of diabetes, and has helped more than 10,000 people improve their metabolic health using low-fat, plant-based, whole-food nutrition, intermittent fasting, and exercise.

Cyrus earned a Bachelor of Science in Mechanical Engineering from Stanford University in 2003, then earned a PhD in Nutritional Biochemistry from the University of California at Berkeley in 2012. He is the co-author of many peer-reviewed scientific publications.

He is the co-host of the annual Mastering Diabetes Online Summit, a featured speaker at the Plant-Based Nutrition and Healthcare Conference (PBNHC), the American College of Lifestyle Medicine Conference (ACLM), Plant Stock, the Torrance Memorial Medical Center, and has been featured on The Doctors, NPR, KQED, Forks Over Knives, Healthline, Fast Company, Diet Fiction, and the wildly popular podcasts the Rich Roll Podcast, Plant Proof, MindBodyGreen, and Nutrition Rounds.

Scientific Publications:

Sarver, Jordan, Cyrus Khambatta, Robby Barbaro, Bhakti Chavan, and David Drozek. “Retrospective Evaluation of an Online Diabetes Health Coaching Program: A Pilot Study.” American Journal of Lifestyle Medicine, October 15, 2019, 1559827619879106. https://doi.org/10.1177/1559827619879106

Shrivastav, Maneesh, William Gibson, Rajendra Shrivastav, Katie Elzea, Cyrus Khambatta, Rohan Sonawane, Joseph A. Sierra, and Robert Vigersky. “Type 2 Diabetes Management in Primary Care: The Role of Retrospective, Professional Continuous Glucose Monitoring.” Diabetes Spectrum: A Publication of the American Diabetes Association 31, no. 3 (August 2018): 279–87. https://doi.org/10.2337/ds17-0024

Thompson, Airlia C. S., Matthew D. Bruss, John C. Price, Cyrus F. Khambatta, William E. Holmes, Marc Colangelo, Marcy Dalidd, et al. “Reduced in Vivo Hepatic Proteome Replacement Rates but Not Cell Proliferation Rates Predict Maximum Lifespan Extension in Mice.” Aging Cell 15, no. 1 (February 2016): 118–27. https://doi.org/10.1111/acel.12414

Roohk, Donald J., Smita Mascharak, Cyrus Khambatta, Ho Leung, Marc Hellerstein, and Charles Harris. “Dexamethasone-Mediated Changes in Adipose Triacylglycerol Metabolism Are Exaggerated, Not Diminished, in the Absence of a Functional GR Dimerization Domain.” Endocrinology 154, no. 4 (April 2013): 1528–39. https://doi.org/10.1210/en.2011-1047

Price, John C., Cyrus F. Khambatta, Kelvin W. Li, Matthew D. Bruss, Mahalakshmi Shankaran, Marcy Dalidd, Nicholas A. Floreani, et al. “The Effect of Long Term Calorie Restriction on in Vivo Hepatic Proteostatis: A Novel Combination of Dynamic and Quantitative Proteomics.” Molecular & Cellular Proteomics: MCP 11, no. 12 (December 2012): 1801–14.

Bruss, Matthew D., Airlia C. S. Thompson, Ishita Aggarwal, Cyrus F. Khambatta, and Marc K. Hellerstein. “The Effects of Physiological Adaptations to Calorie Restriction on Global Cell Proliferation Rates.” American Journal of Physiology. Endocrinology and Metabolism 300, no. 4 (April 2011): E735-745. https://doi.org/10.1152/ajpendo.00661.2010

Bruss, Matthew D., Cyrus F. Khambatta, Maxwell A. Ruby, Ishita Aggarwal, and Marc K. Hellerstein. “Calorie Restriction Increases Fatty Acid Synthesis and Whole Body Fat Oxidation Rates.” American Journal of Physiology. Endocrinology and Metabolism 298, no. 1 (January 2010): E108-116.