Stress as a driver of diabetes 26 July 2023 Historically, the primary risk factors for type 2 diabetes have been attributed to genetics, ethnicity, sedentary lifestyle, poor dietary choices, and being of a higher weight. However, strong and emerging research has shed light on another significant factor that plays a role in the development and progression of chronic health conditions, including diabetes: stress. Firstly, it’s important to remember that stress can influence diabetes in multiple ways. Stress triggers the release of stress hormones, such as cortisol and adrenaline, which can lead to an increase in blood glucose levels. This response is known as the fight-or-flight reaction, where the body prepares itself for perceived threats. The surge in blood glucose levels prompts the pancreas to release insulin, a hormone responsible for transporting glucose from the bloodstream into cells for energy production such as in the muscles. In individuals living with existing diabetes, this stress-induced rise in blood glucose can pose challenges in managing the condition effectively. However, chronic or long-term stress can have detrimental effects on a person’s health, including the potential to contribute to the development of diabetes and difficulties preventing complications when living with diabetes. So, stress can not only exacerbate diabetes but can also increase the risk of developing the condition. Research suggests that long-term exposure to stress hormones can impair insulin’s effectiveness, leading to a condition called insulin resistance. Insulin resistance occurs when cells become less responsive to the hormone’s signals, resulting in higher levels of glucose circulating in the bloodstream. Over time, this can lead to the development of type 2 diabetes, where the body loses its ability to regulate blood glucose effectively. Stress can also indirectly influence diabetes risk through its impact on lifestyle factors. When individuals experience chronic stress, they are more likely to engage in coping mechanisms such as excessive alcohol consumption, smoking, over working, overeating, and physical inactivity which can increase the risk of diabetes or make diabetes difficult to manage, leading to a greater risk of diabetes complications. Furthermore, stress can disrupt sleep patterns, leading to insufficient or poor-quality sleep. Sleep deprivation has been linked to insulin resistance, reduced glucose tolerance, and an increased risk of developing diabetes. The cycle of stress, increased use and reliance on coping mechanisms, disrupted sleep, and impaired glucose regulation creates a fertile ground for the development and progression of diabetes. Recognising the impact of stress on diabetes risk highlights the importance of stress management support and techniques as part of a comprehensive diabetes prevention and management plan. Suggestions for reducing stress and improving social and emotional wellbeing 1. Regular movement: Engaging in physical activity releases endorphins, which are natural mood elevators and stress reducers. Regular enjoyable movement such as going On-Country also helps regulate blood glucose levels and improve insulin sensitivity. 2. Relaxation techniques: Practices such as deep listening, deep breathing, meditation, yoga, and mindfulness have been shown to reduce stress, promote a sense of calm and improve sleep patterns. DREAMY is a collection of sleep stories created by First Nations storytellers which some might find helpful to improve sleep and or relaxation. 3. Social support: Connecting with authentic friends, family, and support groups can provide valuable safe spaces for sharing and receiving social and emotional support. 4. Prioritising self-care: Taking time for activities that bring joy and relaxation, spending time in nature including animals, reading, listening and or playing music, and creating (painting, weaving, knitting, gardening) can help to alleviate and or manage stress and heal. 5. Seeking professional support: In cases where stress becomes overwhelming and starts to impact daily functioning and social and emotional wellbeing, seeking help from a mental health professional can provide valuable guidance and support – the GP can help with a referral to a mental health professional. Looking forward While some stress is helpful and an unavoidable part of life, understanding the impact of high and sustained levels of stress (current and inter-generational) on physical/metabolic health, particularly its role as a driver of diabetes, is crucial. By recognising the relationship between stress, social and emotional wellbeing, and diabetes, individuals can begin to proactively manage stress levels and adopt management mechanisms that are supportive to strong social and emotional wellbeing. Incorporating stress reduction techniques into one’s daily routine, alongside a restorative sleep pattern, helpful social supports, regular movement, and nutrient-rich food choices, can significantly contribute to preventing and or managing diabetes and improving overall social, emotional, and physical wellbeing. For more information on diabetes education for the health workforce and or people living with or at risk of diabetes, please click the Diabetes Australia website here or call the NDSS Helpline on 1800 637 700 to speak with a health professional. By Robbie Tyson, Credentialled Diabetes Educator and Accredited Practising Dietitian
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