Stress on blood sugars, it’s a disaster zone for T1D management.
Believe me, I know this first hand!
My stress levels started to skyrocket about two months ago.
I had a lot of professional responsibilities weighing on me, as well as personal impacts that had my heart racing a little quicker, my mind fluttering like a butterfly, and my skin itching to get away from me.
Most recently, we’ve added a most annoying eye twitch to the mix.
And my blood sugars have skyrocketed too – elevating anywhere from 3-5 or more mmol/L higher than usual, resulting in
- Increased mealtime insulin dosing
- Increased basal rates
- Increased correction doses
That’s because stress on blood sugars wreaks havoc.
I remember when I was still in school, one particular exam where my blood sugars jumped about 6 mmol/L from usual right before the exam. They hovered in that above target range for the entire 4 hours of that exam. But within 15-30 minutes of completion, they completely bottomed out.
My CGM graph was both impressive and scary as heck!
Who else has been here?
Fight or flight
The reason stress impacts blood sugars so significantly is because of epinephrine and cortisol.
Stress activates epinephrine and epinephrine activates cortisol.
Cortisol is a steroid hormone that helps to regulate the body’s response to stress. It’s one of our “fight or flight” hormones that evolved as a survival mechanism for the body to manage life-threatening situations. Among other functions, one of the key aspects of cortisol is to release sugar from the liver and provide a source of fast-acting energy.
Hence high blood sugars during times of stress.
So, how do we manage this?
We can definitely adjust our insulin levels, including mealtime and basal / long-acting, which I inevitably always do. However, this strategy is more of a band-aid solution than a fix-it solution. Plus, it doesn’t always work because cortisol slows down metabolism and increases insulin resistance – essentially, it’s stubborn as hell.
We need to find the root cause of our stress and explore strategies for reducing that stress.
Easier said than done, right.
Suggestions for reducing stress
Stress-reducing strategies are specific to the person; they are individual and they are personal. What works for one person may not work for another. I encourage you to explore things you enjoy, or things you think you might enjoy. Start with 10 minutes a day, and if that’s too much, 5 minutes, and build from there. Try something new or try something that’s worked previously to help calm your brain.
Starting out is the hardest. Because when we’re in these states of stress our energy levels are often in the gutters as well. That’s why I recommend starting slow. Five to 10 minutes a day may not seem like a lot, but it’s more than 0 minutes. And when your mind is frazzled and racing the majority of every other minute of the day, those 5-10 minutes can be a much-needed respite.
Here’s a list of potential stress-reducing strategies that may work for you:
- Running with music or not
- Sipping on a cup of tea outside
- Listening to music
- Making art
- Spinning clay on a potter’s wheel
- Talking to a friend
And if these don’t work, you could always go to Nice 😀